ArticlePatient safety in surgery2026
Validation of the new "Brandenburg Acute Bile Duct (BABD) injury classification" system in 106 patients with accidental bile duct injuries during cholecystectomy.
Article in Patient safety in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBile duct injuries following laparoscopic cholecystectomy are rare but serious complications. Timely diagnosis and optimal management remain challenging. Classification systems for bile duct injuries may facilitate diagnosis, guide treatment, and improve outcomes, however their clinical use is limited. This study systematically evaluated existing classification systems and assessed their applicability to all types of injuries. Based on this analysis, a new classification system for acute lesions was developed.
methodsThe database of the German Arbitration Board for medical liability issues was queried to identify cases involving bile duct injuries following a cholecystectomy (1990-2021). For each patient, the anatomical location, extent of injury, and therapeutic approach were documented. Injuries were categorized according to 11 published classification systems and a newly developed classification system. The ability to categorize bile duct injuries of all systems was assessed.
resultsA total of 106 bile duct injuries were identified. The common bile duct was the most frequently injured structure (31.1%), followed by combined injuries (27.4%), and injuries of the common hepatic duct (17.9%). In 13.2% of cases, an artery was injured in addition to the bile duct lesion. Only 30.2% of bile duct injuries were detected intraoperatively. The most frequently performed techniques were biliodigestive anastomosis (34.4%), direct bile duct anastomosis (31.3%), and leakage closure with stitches (28.1%). None of the 11 existing classifications could categorize all cases; the best-performing systems (Amsterdam, Hannover) classified 82-86%. In contrast, the new Brandenburg Acute Bile Duct Injury (BABD) Classification was able to categorize 99% of the injuries. DISCUSSION: Current classification systems fail to categorize all acute bile duct injuries following cholecystectomies. The BABD Classification, which is based on the anatomical location and extent of injury, allows systematic categorization of all documented acute bile duct lesions and may improve diagnostic clarity, treatment planning, and comparability in future studies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.