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Table 3 ATOM classification [100]

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

Anatomical characteristics Time of detection Mechanism
Anatomic level Type and extent of injury Vasculobiliary injury (yes = VBI+) and name of injured vessel (RHA, LHA, CHA, PV, MV); (no = VBI−) Ei (de visu, bile leak, IOC) Ep L Me ED
Occlusion Division
C P* C P* LS**
MBD
 1            
 2            
 3            
 4            
 5            
 6            
NMBD            
  1. MBD main biliary duct, NMBD non main biliary duct (Luschka duct, aberrant duct, accessory duct), C complete, P, partial, LS, loss of substance, Me, mechanical, ED energy driven, VBI vasculobiliary involvement, RHA right hepatic artery, LHA left hepatic artery, CHA common hepatic artery, PV portal vein, MV marginal vessels, Ei early intraoperative, Ep early postoperative, L late, OC intra-operative cholangiogram
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World Journal of Emergency Surgery

ISSN: 1749-7922