The Bismuth-Corlette classification of hilar cholangiocarcinoma (Klatskin tumor) — Type IV is defined as:

• A Tumor confined to the common hepatic duct
• B Tumor involving confluence with extension into right hepatic duct
• C Tumor involving second-order biliary radicles on both sides ✓
• D Tumor involving confluence with extension into both right and left hepatic ducts

Explanation

The Bismuth-Corlette classification: Type I involves common hepatic duct below confluence; Type II involves the confluence; Type IIIa extends into right hepatic duct; Type IIIb extends into left hepatic duct; Type IV involves second-order biliary radicles bilaterally or is multicentric. Type IV tumors are generally considered unresectable as they require bilateral hepatectomy to achieve clear margins, though some selected cases may be considered for liver transplantation at specialized centers.

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

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Written and medically reviewed by the StethoPrep medical team.