A 62-year-old man is diagnosed with cholangiocarcinoma involving the bifurcation of the hepatic ducts extending into both the right and left hepatic ducts. According to the Bismuth-Corlette classification, what is the type?
- A Type I
- B Type IV ✓
- C Type II
- D Type IIIa or IIIb
Correct answer: B. Type IV
Explanation
The Bismuth-Corlette classification of hilar cholangiocarcinoma (Klatskin tumor): Type I involves the common hepatic duct below the bifurcation; Type II involves the bifurcation; Type IIIa extends into the right hepatic duct; Type IIIb extends into the left hepatic duct; Type IV involves both right and left hepatic ducts (bilateral intrahepatic involvement). A tumor extending into both right and left hepatic ducts is Type IV, which carries the poorest prognosis and is least amenable to curative resection.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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