The Bismuth-Corlette classification of hilar cholangiocarcinoma (Klatskin tumor) is used to guide surgical planning. Which type indicates involvement of the right and left hepatic ductal confluence with extension into both right and left secondary radicles?
- A Type IV ✓
- B Type I
- C Type II
- D Type III
Correct answer: A. Type IV
Explanation
The Bismuth-Corlette classification: Type I = below the confluence; Type II = at the confluence, involving right and left hepatic ducts up to secondary radicles; Type III = involvement extending into secondary radicles on one side (IIIa = right, IIIb = left); Type IV = bilateral involvement of secondary radicles (both sides). Type IV tumors are generally considered unresectable. Types I, II, and III may be resectable with appropriate hepatectomy. Type II involves the confluence but not secondary radicles — this is a common exam confusion point.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.