Iatrogenic Bile Duct Injury Associated with Anomalies of the Right Hepatic Sectoral Ducts: A Misunderstood and Underappreciated Problem

Table 1

Classification of bile duct injuries based on either bile leaks or location of strictures. Right hepatic duct (RHD), common bile duct (CBD), common hepatic duct (CHD). The classification of injuries identified in our patients is highlighted.

Classification/Year		Bismuth [1](1982)	Strasberg [2](1995)	Way [3](2003)
Bile Leak	Cystic duct or terminal biliary radical leak		A
	From CBD/CHD, no tissue loss		D	I
	From CBD/CHD, tissue loss			II
	From RHD (posterior sectoral)		C	IV
	CBD/CHD transection/occlusion			III
Strictures	CBD stricture
	CHD >2 cm	I	E1	III
	CHD <2 cm	II	E2	III
	Hilar stricture, intact confluence	III	E3	III
	Hilar stricture, disrupted	IV	E4	III
	confluence
	Obstructed R posterior hepatic	V	𝐁/𝐄5	IV
	Duct +/−CBD/CHD stricture