Purpose. The study was undertaken to evaluate a novel
classification system developed to estimate financial cost of bile
duct injury (BDI) and to aid in decision making for referral.
Study Design. A retrospective review of
patients referred for BDI was performed. Grade I injuries involve the
duct of Luschka or accessory right hepatic ducts, grade II includes
all other biliary injuries, and grade III includes all vasculobiliary
injuries. Groups were compared using standard statistical methods.
Results. There were 14 grade I, 74 grade II,
and 20 grade III injuries. There was a significant difference in the
cost and mortality of grade I ($12,457, 0%), grade II ($46,481, 1.4%),
and grade III ($69,368, 15%,
resp.) injuries. Grade II and III injuries were significantly more
likely to require surgical repair (OR 27.7,
Conclusion. We have presented a simple
classification system that is able to accurately predict cost and need
for surgical repair.