Korean J Hepatobiliary Pancreat Surg.  2014 Aug;18(3):69-72. 10.14701/kjhbps.2014.18.3.69.

Recent classifications of the common bile duct injury

Affiliations
  • 1Department of Surgery, Chungnam National University Hospital, Daejeon, Korea. oxali@hanmail.net

Abstract

Laparoscopic cholecystectomy is now a gold standard treatment modality for gallstone diseases. However, the incidence rate of bile duct injury has not been changed for many years. From initial classification published by Bismuth, there have been many classifications of common bile duct injury. The initial classification, levels and types of bile duct injury, and currently combined vascular injuries are reviewed here.

Keyword

Bile duct injury; Classification; Laparoscopic cholecystectomy

MeSH Terms

Bile Ducts
Bismuth
Cholecystectomy, Laparoscopic
Classification*
Common Bile Duct*
Gallstones
Incidence
Vascular System Injuries
Bismuth

Figure

  • Fig. 1 Strasberg classification.3,22 (A) Bile leak from cystic duct stump or minor biliary radical in gallbladder fossa. (B) Occluded right posterior sectoral duct. (C) Bile leak from divided right posterior sectoral duct. (D) Bile leak from main bile duct without major tissue loss. (E1) Transected main bile duct with a stricture more than 2 cm from the hilus. (E2) Transected main bile duct with a stricture less than 2 cm from the hilus. (E3) Stricture of the hilus with right and left ducts in communication. (E4) Stricture of the hilus with separation of right and left ducts. (E5) Stricture of the main bile duct and the right posterior sectoral duct.

  • Fig. 2 Stewart-Way classification.15

  • Fig. 3 Hannover classification.16


Reference

1. Sicklick JK, Camp MS, Lillemoe KD, Melton GB, Yeo CJ, Campbell KA, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients. Ann Surg. 2005; 241:786–792. PMID: 15849514.
2. McMahon AJ, Fullarton G, Baxter JN, O'Dwyer PJ. Bile duct injury and bile leakage in laparoscopic cholecystectomy. Br J Surg. 1995; 82:307–313. PMID: 7795992.
Article
3. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995; 180:101–125. PMID: 8000648.
4. Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, et al. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg. 1996; 224:609–620. PMID: 8916876.
5. Targarona EM, Marco C, Balagué C, Rodriguez J, Cugat E, Hoyuela C, et al. How, when, and why bile duct injury occurs. A comparison between open and laparoscopic cholecystectomy. Surg Endosc. 1998; 12:322–326. PMID: 9543521.
6. Lillemoe KD, Melton GB, Cameron JL, Pitt HA, Campbell KA, Talamini MA, et al. Postoperative bile duct strictures: management and outcome in the 1990s. Ann Surg. 2000; 232:430–441. PMID: 10973393.
Article
7. Gazzaniga GM, Filauro M, Mori L. Surgical treatment of iatrogenic lesions of the proximal common bile duct. World J Surg. 2001; 25:1254–1259. PMID: 11596885.
Article
8. Savar A, Carmody I, Hiatt JR, Busuttil RW. Laparoscopic bile duct injuries: management at a tertiary liver center. Am Surg. 2004; 70:906–909. PMID: 15529848.
9. Moore DE, Feurer ID, Holzman MD, Wudel LJ, Strickland C, Gorden DL, et al. Long-term detrimental effect of bile duct injury on health-related quality of life. Arch Surg. 2004; 139:476–481. PMID: 15136346.
Article
10. Misra S, Melton GB, Geschwind JF, Venbrux AC, Cameron JL, Lillemoe KD. Percutaneous management of bile duct strictures and injuries associated with laparoscopic cholecystectomy: a decade of experience. J Am Coll Surg. 2004; 198:218–226. PMID: 14759778.
Article
11. Gentileschi P, Di Paola M, Catarci M, Santoro E, Montemurro L, Carlini M, et al. Bile duct injuries during laparoscopic cholecystectomy: a 1994-2001 audit on 13,718 operations in the area of Rome. Surg Endosc. 2004; 18:232–236. PMID: 14691705.
Article
12. Kaman L, Sanyal S, Behera A, Singh R, Katariya RN. Comparison of major bile duct injuries following laparoscopic cholecystectomy and open cholecystectomy. ANZ J Surg. 2006; 76:788–791. PMID: 16922899.
Article
13. Ahrendt SA, Pitt HA. Surgical therapy of iatrogenic lesions of biliary tract. World J Surg. 2001; 25:1360–1365. PMID: 11596904.
Article
14. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001; 25:1241–1244. PMID: 11596882.
Article
15. Stewart L, Domingez CO, Way LW. Bile duct injuries during laparoscopic cholecystectomy: a sensemaking analysis of operative reports. In : Mosier K, Fischer U, editors. Proceedings of the 8th International NDM Conference. 2007 Jun; Pacific Grove, CA. [publisher unknown]: 2007.
16. Bektas H, Schrem H, Winny M, Klempnauer J. Surgical treatment and outcome of iatrogenic bile duct lesions after cholecystectomy and the impact of different clinical classification systems. Br J Surg. 2007; 94:1119–1127. PMID: 17497652.
Article
17. Mattox KL, Feliciano DV, Moore EE. Trauma. 3rd ed. Stamford, CT: Applenton & Lange;1996. p. 515–519.
18. Schmidt SC, Settmacher U, Langrehr JM, Neuhaus P. Management and outcome of patients with combined bile duct and hepatic arterial injuries after laparoscopic cholecystectomy. Surgery. 2004; 135:613–618. PMID: 15179367.
Article
19. Bergman JJ, van den Brink GR, Rauws EA, de Wit L, Obertop H, Huibregtse K, et al. Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut. 1996; 38:141–147. PMID: 8566842.
Article
20. Csendes A, Navarrete C, Burdiles P, Yarmuch J. Treatment of common bile duct injuries during laparoscopic cholecystectomy: endoscopic and surgical management. World J Surg. 2001; 25:1346–1351. PMID: 11596901.
Article
21. Lau WY, Lai EC. Classification of iatrogenic bile duct injury. Hepatobiliary Pancreat Dis Int. 2007; 6:459–463. PMID: 17897905.
22. Sahajpal AK, Chow SC, Dixon E, Greig PD, Gallinger S, Wei AC. Bile duct injuries associated with laparoscopic cholecystectomy: timing of repair and long-term outcomes. Arch Surg. 2010; 145:757–763. PMID: 20713928.
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