AAST extrahepatic biliary tree injury scale

Grade*	Description of injury
I	Gallbladder contusion/hematoma
I	Portal triad contusion
II	Partial gallbladder avulsion from liver bed; cystic duct intact
II	Laceration or perforation of the gallbladder
III	Complete gallbladder avulsion from liver bed
III	Cystic duct laceration
IV	Partial or complete right hepatic duct laceration
	Partial or complete left hepatic duct laceration
	Partial common hepatic duct laceration (<50%)
	Partial common bile duct laceration (<50%)
V	>50% transection of common hepatic duct
	>50% transection of common bile duct
	Combined right and left hepatic duct injuries
	Intraduodenal or intrapancreatic bile duct injuries

AAST: American Association for the Surgery of Trauma.
* Advance one grade for multiple injuries up to grade III.

Reproduced with permission from: Moore EE, Jurkovich GJ, Knudson MM, et al. Organ injury scaling. VI: Extrahepatic biliary, esophagus, stomach, vulva, vagina, uterus (nonpregnant), uterus (pregnant), fallopian tube, and ovary. J Trauma 1995; 39:1069. Copyright © 1995 Lippincott Williams & Wilkins. Available at: https://www.aast.org/resources-detail/injury-scoring-scale#tree (Accessed on December 10, 2019).

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AAST extrahepatic biliary tree injury scale