Iatrogenic Bile Duct Injury-MRCP

This is a 25 year old post cholecystectomy status female with collection in the GB fossa and suspected Bismuth type I injury. The overall incidence of ductal injury during laparoscopic cholecystectomy is 1.2% or less. Postoperative bile duct injury may be classified as a leak, stricture, or complete transection and excision of a segment of duct, with or without obstruction of the proximal biliary tree by surgical clips. According to Bismuth classifications of traumatic bile duct injury--

1. Type I is injury more than 2 cm distal to biliary bifurcation.


2. Type II is less than 2 cm from biliary confluence.


3. Type III injury involves entire common hepatic duct and leaves confluence intact.


4. Type IV is complete or partial destruction of biliary bifurcation.