Neimeier classification of gallbladder perforation

Last revised by Daniel J Bell on 13 Nov 2021

The classification of gallbladder perforation was proposed by Neimeier and later modified by Anderson et al. in 1987, which at the time of writing remains the most widely accepted classification for gallbladder perforation.

According to this classification, there are three main clinical subtypes. A fourth type is suggested by Anderson et al. 1:

  • type I: acute free perforation
  • type II: subacute pericholecystic abscess
  • type III: chronic cholecystoenteric fistulation
  • type IV: cholecystobiliary fistula formation

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