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Videosurgery and Other Miniinvasive Techniques
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1/2018
vol. 13
 
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abstract:
Original paper

Cost-effectiveness of benign Wirsung duct strictures treatment in chronic pancreatitis

Dariusz Łaski
,
Stanisław Hać
,
Iwona Marek
,
Jarosław Kobiela
,
Justyna Kostro
,
Krystian Adrych
,
Zbigniew Śledziński

Videosurgery Miniinv 2018; 13 (1): 17–26
DOI: https://doi.org/10.5114/wiitm.2018.72578
Online publish date: 2018/01/04
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Introduction
Chronic pancreatitis (CP) is an important problem for modern medicine, the healthcare system (Poland – NFZ) and the national insurance system (Poland – ZUS). The chronic nature of the disease, the lack of targeted treatment and the low mortality rate lead to an accumulation of patients who demand expensive treatment, both conservative and invasive. Rising costs in health care are forcing the need for a more cost-effective method of treatment.

Aim
The primary aim of this study was to perform a retrospective calculation of costs in both surgical and endoscopic treatment, hospital stay, healthcare, and public insurance of patients suffering from chronic pancreatitis. Parallel quality of life analysis was performed. It was possible to develop a cost-effective therapeutic algorithm for patients with an uncomplicated stricture of Wirsung’s duct within the Polish health care system.

Results
In Poland, the hospital costs of endoscopic treatment of patients with chronic pancreatitis were higher than those of the surgical treatment group despite both resulting in a similar life quality.

Conclusions
From a cost-effectiveness perspective, it was shown that surgical intervention is a more cost-effective therapy than endotherapy. Furthermore, patients with benign stricture of the main pancreatic duct in chronic pancreatitis should not be treated with endotherapy for longer than 12 months.

keywords:

chronic pancreatitis, endotherapy, surgical drainage procedures, Wirsung duct stricture, cost-effectiveness
  
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