Table of Contents
HPB Surgery
Volume 2011, Article ID 371245, 6 pages
http://dx.doi.org/10.1155/2011/371245
Research Article

A Novel Classification System to Address Financial Impact and Referral Decisions for Bile Duct Injury in Laparoscopic Cholecystectomy

1Department of Surgery, University of Louisville, Louisville, KY 40202, USA
2Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, University of Louisville, Louisville, KY 40202, USA
3Tulane Abdominal Transplant Institute, Department of Surgery, Tulane University, New Orleans, LA 70112, USA

Received 8 April 2011; Revised 27 June 2011; Accepted 12 July 2011

Academic Editor: Harald Schrem

Copyright © 2011 Robert M. Cannon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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%, 𝑃 = 0 . 0 0 2 and 𝑃 = 0 . 0 3 0 , resp.) injuries. Grade II and III injuries were significantly more likely to require surgical repair (OR 27.7, 𝑃 < 0 . 0 0 1 ). Conclusion. We have presented a simple classification system that is able to accurately predict cost and need for surgical repair.