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

Author:

Cannon Robert M.1,Brock Guy2,Buell Joseph F.3

Affiliation:

1. Department of Surgery, University of Louisville, Louisville, KY 40202, USA

2. Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, University of Louisville, Louisville, KY 40202, USA

3. Tulane Abdominal Transplant Institute, Department of Surgery, Tulane University, New Orleans, LA 70112, USA

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%, and , 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.

Publisher

Hindawi Limited

Subject

Hepatology,Surgery

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