During laparoscopic cholecystectomy, an intraoperative cholangiogram reveals a filling defect in the distal common bile duct. The cystic duct is short and the patient has been jaundiced for 3 days. According to Strasberg's classification, an injury where the common bile duct is completely transected and a segment is excised is classified as:
- A Type A
- B Type E3 ✓
- C Type D
- D Type E5
Explanation
The Strasberg classification of bile duct injuries: Type A = cystic duct leak or small ductal leaks; Type B = occlusion of aberrant right hepatic duct; Type C = transection of aberrant right hepatic duct without ligation; Type D = lateral injury to CBD; Type E (E1–E5) = circumferential injuries (modified Bismuth). E3 = injury to common hepatic duct within 2 cm of the hilum. E5 = injury to an aberrant right sectoral duct plus main hepatic duct. Complete transection of the CBD with segment excision corresponds to E2 or E3 depending on the level. E3 is a transection < 2 cm from the hepatic confluence.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.