Use of a saline-coupled bipolar sealer open liver resection for hepatic malignancy: Medical resource use and costs

AIM To evaluate outcomes associated with use of a saline coupled bipolar sealer during open partial liver resection.METHODS This retrospective analysis utilized the United States Premier? insurance claims database(2010-2014). Patients were selected with codes for liver malignancy and partial hepatectomy or lobectomy. Cases were defined by use the saline-coupled bipolar sealer; controls had no use. A Propensity Score algorithm was used to match one case to five controls. A deviationbased cost modeling(DBCM) approach provided an estimate of cost-effectiveness.RESULTS One hundred and forty-four cases and 720 controls were available for analysis. Patients in the case cohort received fewer transfusions vs controls(18.1% vs 29.4%, P = 0.007). In DBCM, more patients in the case cohort experienced 'on-course' hospitalizations(53.5% vs 41.9%, P = 0.009). The cost calculation showed an average savings in total hospitalization costs of $1027 for cases vs controls. In multivariate analysis, cases had lower odds of receiving a transfusion(OR = 0.44, 95%CI: 0.27-0.71, P = 0.0008).CONCLUSION Use of a saline-coupled bipolar sealer was associated with a greater proportion of patients with an 'on course' hospitalization.