Bismuth-Corlette classification is used for hilar cholangiocarcinoma (Klatskin tumour). Which type is considered potentially resectable with hepatic lobectomy?

• A Type I — confined to common hepatic duct below the confluence
• B Type IV — involves both left and right second-order radicles (generally unresectable)
• C Type IIIa — extends into right second-order radicles (requires right hepatectomy) ✓
• D Type II — involves the confluence only, requiring wedge resection

Explanation

Bismuth-Corlette classification: Type I — below confluence; Type II — involves confluence; Type IIIa — extends into right hepatic duct radicles requiring right hepatectomy; Type IIIb — extends into left hepatic duct radicles requiring left hepatectomy; Type IV — bilateral second-order involvement. Types I, II, IIIa, and IIIb are potentially resectable with curative intent, with Types III requiring major hepatectomy. Type IV is classically considered unresectable but highly selected patients may undergo extended hepatectomy at specialist centres. Resectability also depends on future liver remnant volume and vascular involvement.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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