In the Bismuth-Corlette classification of hilar cholangiocarcinoma (Klatskin tumor), a Type IV lesion involves:

• A The common hepatic duct below the confluence
• B The confluence only (hepatic duct bifurcation)
• C The common bile duct extending to cystic duct junction
• D Involvement of right and left secondary intrahepatic radicles ✓

Explanation

Bismuth-Corlette classification: Type I — CHD below confluence; Type II — confluence involved; Type IIIa — right secondary radicle involved; Type IIIb — left secondary radicle involved; Type IV — both right and left secondary intrahepatic radicles involved (multicentric or bilateral extension). Type IV lesions are generally considered unresectable. Type I lesions (below confluence) have the best resectability rates.

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

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