Surgery · Hepatobiliary Surgery (Liver Tumors, Gall Bladder, Bile Duct, Pancreas)

A patient undergoes laparoscopic cholecystectomy. The bile duct is injured and a segment of 1.5 cm of the common bile duct is excised. According to the Strasberg classification, this injury is classified as:

  • A Type C
  • B Type E2
  • C Type D
  • D Type E4
Correct answer: B. Type E2

Explanation

The Strasberg classification categorizes bile duct injuries from laparoscopic cholecystectomy. Type A: cystic duct leak or leak from minor duct in gallbladder fossa. Type B: occluded aberrant right hepatic duct. Type C: divided aberrant right hepatic duct. Type D: lateral injury to major duct. Type E injuries (E1-E5) correspond to the Bismuth classification for major bile duct strictures/transections: E1 — common bile duct stump >2 cm; E2 — stump <2 cm (mid-CHD); E3 — at hilum; E4 — right and left ducts separated; E5 — combined right sectoral duct. A 1.5 cm segment resection at the common duct corresponds to Type E2.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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