Profit and Loss Analysis of Different Surgical Approaches to Pancreatectomy

Abstract

Purpose: To analyze revenue and expenditure for pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) using open, laparoscopic and robot-assisted approaches. Methods: To compare the profit and loss difference based on cost accounting for each type of approach. Results: Although laparoscopic PD and robot-assisted PD had higher income, the profit/loss difference in robot-assisted PD was comparable to that of open PD due to increased expenditure. The break-even point obtained with operating time as a variable was profitable for all approaches in PD. The break-even point calculated using labor costs for surgery by the General Association of Surgical Society Social Insurance Commission Union resulted in no profitability for either approach. In the case of DP, profitability was achieved for open and laparoscopic DP, but not for robot-assisted DP. Conclusion: From a healthcare management perspective, introduction of robot-assisted surgery in PD is acceptable, but robot-assisted DP should only be performed within the scope of management strategy, as the income/expense break-even point is highly negatively biased. From a medical management perspective, introduction of robot-assisted surgery for PD is also acceptable; however, as robot-assisted DP is currently biased toward a negative balance between profit and loss, it should be implemented based on a comprehensive judgment that also takes into account management strategy.