A 55-year-old jaundiced man has a Bismuth-Corlette type IIIa hilar cholangiocarcinoma on MRCP. This classification indicates that the tumor involves:
- A Confluence of hepatic ducts only
- B Common hepatic duct and left second-order hepatic ducts
- C Common hepatic duct and right second-order hepatic ducts ✓
- D All second-order ducts bilaterally with no resectable margin
Correct answer: C. Common hepatic duct and right second-order hepatic ducts
Explanation
The Bismuth-Corlette classification: Type I (CHD below confluence), Type II (at confluence), Type IIIa (confluence + right hepatic duct), Type IIIb (confluence + left hepatic duct), Type IV (bilateral second-order ducts). Type IIIa requires right hepatectomy with caudate lobe resection for R0 resection, while IIIb requires left hepatectomy with caudate lobe removal. Type IV is generally unresectable. The caudate lobe must be removed with all types ≥II because it drains directly into the confluence via multiple small ducts.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.