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Recent classifications of the common bile duct injury.

Chun K - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chungnam National University Hospital, Daejeon, Korea.

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.

No MeSH data available.


Related in: MedlinePlus

Hannover classification.16
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Figure 3: Hannover classification.16

Mentions: Bektas et al. proposed a new classification system named Hannover classification after comparing the classification of bile duct injury for consecutive 72 iatrogenic bile injuries after laparoscopic cholecystectomy. In the Hannover, bile duct injuries were divided into five types from A to E.16 Type A is peripheral bile leakage. Type B is stricture of CHD or CBD without injury. Type C is lateral CHD or CBD injury. Type D is total transection of CHD. Type E is bile duct stricture of the main bile duct without bile leakage at postoperative state. Vascular injuries are included in Type C and Type D (Fig. 3). The Hannover classification distinguished a total of 21 injury patterns in a small group of patients. The advantage of the Hannover classification is that it has a high level of statistical significance to demonstrate the association between the discrimination of classifiable injury patterns and the surgical treatments chosen. Other classification systems could only distinguish fewer injury patterns. Furthermore, with the Hannover classification, there were significant associations between the discrimination of specific injury patterns and the resection of liver tissue as well as resection of the bifurcation of the hepatic duct. The advantage of the Neuhaus' classification may be the ability to discriminate different injury patterns and recurrent cholangitis in the long-term. This Hannover classification provides discriminators for the localization of tangentially or completely transected bile ducts above or below the bifurcation of the hepatic duct, which is a major drawback of other classification systems.


Recent classifications of the common bile duct injury.

Chun K - Korean J Hepatobiliary Pancreat Surg (2014)

Hannover classification.16
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492327&req=5

Figure 3: Hannover classification.16
Mentions: Bektas et al. proposed a new classification system named Hannover classification after comparing the classification of bile duct injury for consecutive 72 iatrogenic bile injuries after laparoscopic cholecystectomy. In the Hannover, bile duct injuries were divided into five types from A to E.16 Type A is peripheral bile leakage. Type B is stricture of CHD or CBD without injury. Type C is lateral CHD or CBD injury. Type D is total transection of CHD. Type E is bile duct stricture of the main bile duct without bile leakage at postoperative state. Vascular injuries are included in Type C and Type D (Fig. 3). The Hannover classification distinguished a total of 21 injury patterns in a small group of patients. The advantage of the Hannover classification is that it has a high level of statistical significance to demonstrate the association between the discrimination of classifiable injury patterns and the surgical treatments chosen. Other classification systems could only distinguish fewer injury patterns. Furthermore, with the Hannover classification, there were significant associations between the discrimination of specific injury patterns and the resection of liver tissue as well as resection of the bifurcation of the hepatic duct. The advantage of the Neuhaus' classification may be the ability to discriminate different injury patterns and recurrent cholangitis in the long-term. This Hannover classification provides discriminators for the localization of tangentially or completely transected bile ducts above or below the bifurcation of the hepatic duct, which is a major drawback of other classification systems.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chungnam National University Hospital, Daejeon, Korea.

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.

No MeSH data available.


Related in: MedlinePlus