Skip to main content

Table 2 Summary of the most commonly used BDI classification systems

From: 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

 

BDI classification systems

Bismuth [92, 93]

Strasberg [90]

McMahon [94]

Bergman [95]

Csendes [97]

Stewart-Way [98, 103]

Hannover [17]

Lau [99]

ATOM [100]

Bile leakage

 Cystic duct leak or leaks from small ducts in liver bed

 

A

 

A

Type I

 

Type A

Type 1

NMBD

 Occlusion of an aberrant RHD

 

B

     

Type 2

 

 Leak from an aberrant RHD

 

C

       

 Lateral injury to CBD < 50% diameter

 

D

     

Type 2

 

 Laceration > 25% of CBD

  

Major bile duct injury

B

     

 Transection of CBD or CHD

  

Major bile duct injury

D

Type III

Class II/III

Type D

Type 3

 

 Resection od more than 10 mm of the CBD

    

Type IV

    

 Tangential injury of the CBD

      

Type C

  

 Right/left hepatic duct or sectoral duct injuries

       

Type 4

 

 Laceration < 25% of CBD

  

Minor bile duct injury

  

Class I

   

 Laceration of cystic-CBD junction

  

Minor bile duct injury

 

Type II

    

Bile stricture

 Stenosis of the main bile duct without injury (caused by a clip)

      

Type B

  

 CBD stump > 2 cm

Type I

EI

      

MBD 1

 CBD stump < 2 cm

Type II

E2

      

MBD 2

 Ceiling of the biliary confluence is intact

Type III

E3

      

MBD 3

 Ceiling of the confluence is destroyed

Type IV

E4

      

MBD 4

 Type I, II or III + stricture of an isolated right duct

Type V

E5

       

 Development of post-operative CBD stricture

  

Major bile duct injury

C

  

Type E

  

Vascular lesion

 Right hepatic artery + RHD transected

     

Class IV

Type D

Type 5

VBI+

  1. RHD right hepatic duct, CBD common bile duct, CHD common hepatic duct, NMBD non-main bile duct, MBD main bile duct, VBI vasculobiliary injury