What is Strasberg classification?

Strasberg classification:

Type A – Injury to the cystic duct or from minor hepatic ducts draining the liver bed. Type B – Occlusion of biliary tree, commonly aberrant right hepatic duct(s). Type C – Transection without ligation of aberrant right hepatic duct(s). Type D – Lateral injury to a major bile duct.

Which is the most common type of bile duct injury?

Class III injuries are the most common type, occurring in 60% of cases. Subdivision class IIIa injuries have a remnant of common hepatic duct, while class IIIb involves transection at the junction of the cystic duct-CHD. In class IIIc, the bifurcation has been excised with complete loss of the confluence.

What does Bismuth classification of bile duct injuries describe?

type D: lateral injury to a major bile duct. type E: injury to the main hepatic duct; classified according to the level of injury. E1 (Bismuth type 1): injury more than 2 cm from the confluence. E2 (Bismuth type 2): injury less than 2 cm from the confluence. E3 (Bismuth type 3): injury at the confluence; confluence …

What are the two types of bile duct?

The two ducts join outside the liver and form the common hepatic duct. The cystic duct from the gallbladder joins the common hepatic duct to form the common bile duct. The common bile duct passes through the pancreas and ends in the small intestine. Bile is made by the liver and stored in the gallbladder.

How is common bile duct injury diagnosed?

Endoscopic retrograde cholangiopancreatography (ERCP): This test uses a lighted, flexible scope inserted into the upper part of the digestive system to look at and take X-rays of the bile ducts. Sometimes, bile duct injuries can also be treated using ERCP.

What is Hepatocystic triangle?

Hepatocystic triangle (aka Calot’s triangle) is a small (potential) triangular space at the porta hepatis of surgical importance as it is dissected during cholecystectomy. Its contents, the cystic artery and cystic duct must be identified before ligation and division to avoid intraoperative injury.

What is in the portal triad?

The portal triad is contained within the hepatoduodenal ligament and contains the portal vein (posterolateral), hepatic artery (medial), and bile ducts (lateral) (figure 1). Variations in portal triad anatomy are relatively common (figure 2) [1].

What is the size of common bile duct?

The mean diameter of common bile duct was observed to be 4.1 mm (SD 0.95 mm) for males and 4.0 mm (SD 1.07 mm) for females.

What causes bile duct injury?

The most common cause of bile duct injuries is trauma to the bile duct during a laparoscopic cholecystectomy (gallbladder surgery). It is estimated that as many as 1% of gallbladder operations may lead to injury to the bile duct with subsequent development of a bile duct stricture.

How do you fix a common bile duct injury?

These injuries can typically be repaired primarily with sutures and placement of abdominal drains in the area [102]. Conversely, major BDIs (i.e., Strasberg E) are associated with tissue loss (e.g., the common bile duct is clipped and transected) and require complex reconstruction with a Roux-en-Y hepaticojejunostomy.

What is biliary peritonitis?

Biliary peritonitis is caused by perforation of the gallbladder, bile duct, or upper gastrointestinal tract [4, 5]. Nontraumatic perforation of the bile duct is a disease in which the extrahepatic duct or intrahepatic duct is perforated spontaneously without traumatic or iatrogenic injury [7].

What is choledochal cyst?

What is a choledochal cyst? A choledochal cyst is a congenital anomaly of the duct (tube) that transports bile from the liver to the gall bladder and small intestine. The liver produces bile to help digest food. When a child has a choledochal cyst, a swelling of that duct, bile may back up in the liver.

Can a damaged bile duct be repaired?

Many major bile duct injuries will require surgical repair. There are many described techniques for complex biliary injury repairs including primary repair or primary end-to-end anastomosis of bile ducts, choledochoduodenostomy, and cholecystojejunostomy.

What happens if the bile duct is damaged?

The bile ducts carry bile from your liver to your small intestine. When bile ducts become damaged, bile can back up into the liver, causing damage to liver cells. This damage can lead to liver failure.

How long does it take for bile ducts to heal?

How soon will I recover? You should be able to go home after 1 to 2 days if you had keyhole surgery or after 4 to 5 days if you had open surgery. You should be able to return to work after 3 to 4 weeks, depending on how much surgery you need and your type of work.

Do bile duct leaks heal themselves?

In our experience, drainage of 200 ml or less of bile per day, and reducing over a period of a few days, is likely to subside on its own. In some cases, this may be all that is necessary and the bile leak will slowly reduce and stop.

What is bile duct surgery called?

Along with the bile duct and nearby lymph nodes, the surgeon often has to remove part of the pancreas and small intestine. This operation is called a Whipple procedure.