A 48-year-old man undergoes ERCP for obstructive jaundice. Cholangiogram shows a stricture at the confluence of the right and left hepatic ducts extending into both ducts. According to the Bismuth-Corlette classification, this is which type?

• A Type II
• B Type IIIa
• C Type I
• D Type IV ✓

Explanation

The Bismuth-Corlette classification of hilar cholangiocarcinoma (Klatskin tumour): Type I — below confluence; Type II — at confluence involving both hepatic ducts; Type IIIa — extends into right hepatic duct; Type IIIb — extends into left hepatic duct; Type IV — extends into both right and left hepatic ducts. This case with involvement of the confluence AND both ducts represents Type IV, which is generally considered unresectable.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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