Abstract
Iatrogenic bile duct injury is a rare but potentially catastrophic complication of cholecystectomy. Prompt recognition and treatment are required to minimize the morbidity associated with these injuries. Numerous classification systems have been described to facilitate the study and management of these complications, yet no individual system has been universally adopted. This chapter discusses the major classification systems and compares them based upon their inclusivity of injury type, the ease of use of the system, and the prognostic value associated with the classification. Further research into the prognostic significance of the various injury types is needed, and such research may help to ultimately determine which classification system is adopted as the universal system going forward.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Pellegrini CA, Thomas MJ, Way LW. Recurrent biliary stricture. Patterns of recurrence and outcome of surgical therapy. Am J Surg. 1984;147(1):175–80.
Boerma D, Rauws EA, Keulemans YC, et al. Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis. Ann Surg. 2001;234(6):750–7.
Traverso LW. Carl Langenbuch and the first cholecystectomy. Am J Surg. 1976;132(1):81–2.
Braasch JW. Historical perspectives of biliary tract injuries. Surg Clin North Am. 1994;74(4):731–40.
Flum DR, Dellinger EP, Cheadle A, Chan L, Koepsell T. Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy. JAMA. 2003;289(13):1639–44.
Reynolds Jr W. The first laparoscopic cholecystectomy. JSLS. 2001;5(1):89–94.
Csikesz NG, Singla A, Murphy MM, Tseng JF, Shah SA. Surgeon volume metrics in laparoscopic cholecystectomy. Dig Dis Sci. 2010;55(8):2398–405.
Flum DR, Cheadle A, Prela C, Dellinger EP, Chan L. Bile duct injury during cholecystectomy and survival in medicare beneficiaries. JAMA. 2003;290(16):2168–73.
Nuzzo G, Giuliante F, Giovannini I, et al. Bile duct injury during laparoscopic cholecystectomy: results of an Italian national survey on 56 591 cholecystectomies. Arch Surg. 2005;140(10):986–92.
Waage A, Nilsson M. Iatrogenic bile duct injury: a population-based study of 152 776 cholecystectomies in the Swedish Inpatient Registry. Arch Surg. 2006;141(12):1207–13.
Booij KA, de Reuver PR, van Delden OM, Gouma DJ. [Conversion has to be learned: bile duct injury following conversion to open cholecystectomy]. Ned Tijdschr Geneeskd. 2009;153:A296.
Archer SB, Brown DW, Smith CD, Branum GD, Hunter JG. Bile duct injury during laparoscopic cholecystectomy: results of a national survey. Ann Surg. 2001;234(4):549–58. discussion 558–9.
Massarweh NN, Devlin A, Symons RG, Broeckel Elrod JA, Flum DR. Risk tolerance and bile duct injury: surgeon characteristics, risk-taking preference, and common bile duct injuries. J Am Coll Surg. 2009;209(1):17–24.
Hunter JG. Avoidance of bile duct injury during laparoscopic cholecystectomy. Am J Surg. 1991;162(1):71–6.
Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg. 2003;237(4):460–9.
Tornqvist B, Stromberg C, Persson G, Nilsson M. Effect of intended intraoperative cholangiography and early detection of bile duct injury on survival after cholecystectomy: population based cohort study. BMJ. 2012;345:e6457.
Melton GB, Lillemoe KD, Cameron JL, Sauter PA, Coleman J, Yeo CJ. Major bile duct injuries associated with laparoscopic cholecystectomy: effect of surgical repair on quality of life. Ann Surg. 2002;235(6):888–95.
de Reuver PR, Sprangers MA, Rauws EA, et al. Impact of bile duct injury after laparoscopic cholecystectomy on quality of life: a longitudinal study after multidisciplinary treatment. Endoscopy. 2008;40(8):637–43.
Landman MP, Feurer ID, Moore DE, Zaydfudim V, Pinson CW. The long-term effect of bile duct injuries on health-related quality of life: a meta-analysis. HPB (Oxford). 2013;15(4):252–9.
Hogan AM, Hoti E, Winter DC, et al. Quality of life after iatrogenic bile duct injury: a case control study. Ann Surg. 2009;249(2):292–5.
Bismuth H. Postoperative strictures of the bile ducts, vol. V. New York, NY: Churchill-Livingstone; 1982.
Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001;25(10):1241–4.
Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180(1):101–25.
Reid SH, Cho SR, Shaw CI, Turner MA. Anomalous hepatic duct inserting into the cystic duct. AJR Am J Roentgenol. 1986;147(6):1181–2.
Couinaud C. Le foie; etudes anatomiques et chirurgicales. Paris: Masson; 1957.
Eum YO, Park JK, Chun J, et al. Non-surgical treatment of post-surgical bile duct injury: clinical implications and outcomes. World J Gastroenterol. 2014;20(22):6924–31.
Chinnery GE, Krige JE, Bornman PC, et al. Endoscopic management of bile leaks after laparoscopic cholecystectomy. S Afr J Surg. 2013;51(4):116–21.
Sandha GS, Bourke MJ, Haber GB, Kortan PP. Endoscopic therapy for bile leak based on a new classification: results in 207 patients. Gastrointest Endosc. 2004;60(4):567–74.
Pitt HA, Sherman S, Johnson MS, et al. Improved outcomes of bile duct injuries in the 21st century. Ann Surg. 2013;258(3):490–9.
Bergman JJ, van den Brink GR, Rauws EA, et al. Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut. 1996;38(1):141–7.
Neuhaus P, Schmidt SC, Hintze RE, et al. [Classification and treatment of bile duct injuries after laparoscopic cholecystectomy]. Chirurg. 2000;71(2):166–73.
Stewart L, Robinson TN, Lee CM, Liu K, Whang K, Way LW. Right hepatic artery injury associated with laparoscopic bile duct injury: incidence, mechanism, and consequences. J Gastrointest Surg. 2004;8(5):523–30. discussion 530–1.
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(9):1119–27.
Lau WY, Lai EC. Classification of iatrogenic bile duct injury. Hepatobiliary Pancreat Dis Int. 2007;6(5):459–63.
Cannon RM, Brock G, Buell JF. A novel classification system to address financial impact and referral decisions for bile duct injury in laparoscopic cholecystectomy. HPB Surg. 2011;2011:371245.
Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg. 1993;165(1):9–14.
Halasz NA. Cholecystectomy and hepatic artery injuries. Arch Surg. 1991;126(2):137–8.
Li J, Frilling A, Nadalin S, Broelsch CE, Malago M. Timing and risk factors of hepatectomy in the management of complications following laparoscopic cholecystectomy. J Gastrointest Surg. 2012;16(4):815–20.
Truant S, Boleslawski E, Lebuffe G, Sergent G, Pruvot FR. Hepatic resection for post-cholecystectomy bile duct injuries: a literature review. HPB (Oxford). 2010;12(5):334–41.
Keulemans YC, Bergman JJ, de Wit LT, et al. Improvement in the management of bile duct injuries? J Am Coll Surg. 1998;187(3):246–54.
Llach J, Bordas JM, Elizalde JI, et al. Sphincterotomy in the treatment of biliary leakage. Hepatogastroenterology. 2002;49(48):1496–8.
Fingerhut A, Dziri C, Garden OJ, et al. ATOM, the all-inclusive, nominal EAES classification of bile duct injuries during cholecystectomy. Surg Endosc. 2013;27(12):4608–19.
Siewert JR, Ungeheuer A, Feussner H. [Bile duct lesions in laparoscopic cholecystectomy]. Chirurg. 1994;65(9):748–57.
McMahon AJ, Fullarton G, Baxter JN, O’Dwyer PJ. Bile duct injury and bile leakage in laparoscopic cholecystectomy. Br J Surg. 1995;82(3):307–13.
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(10):1346–51.
Kapoor VK. New classification of acute bile duct injuries. Hepatobiliary Pancreat Dis Int. 2008;7(5):555–6.
Li J, Frilling A, Nadalin S, et al. Surgical management of segmental and sectoral bile duct injury after laparoscopic cholecystectomy: a challenging situation. J Gastrointest Surg. 2010;14(2):344–51.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Bartlett, E.K., Vollmer, C.M. (2015). The Classification and Injury Patterns of Iatrogenic Bile Duct Injury During Laparoscopic Cholecystectomy. In: Dixon, E., Vollmer Jr., C., May, G. (eds) Management of Benign Biliary Stenosis and Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-22273-8_18
Download citation
DOI: https://doi.org/10.1007/978-3-319-22273-8_18
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-22272-1
Online ISBN: 978-3-319-22273-8
eBook Packages: MedicineMedicine (R0)