The Bismuth-Corlette classification of hilar cholangiocarcinoma (Klatskin tumour) divides tumours by ductal involvement. A Type IIIb tumour involves:

• A Common hepatic duct and both right and left hepatic ducts
• B Common hepatic duct and left hepatic duct extending to left sectoral ducts ✓
• C Common hepatic duct and right hepatic duct with right sectoral ducts
• D All intrahepatic ducts bilaterally — unresectable

Explanation

Bismuth-Corlette: Type I — CHD only; Type II — bifurcation; Type IIIa — right hepatic duct involvement; Type IIIb — left hepatic duct involvement extending to second-order ducts on the left; Type IV — bilateral second-order duct involvement. Type IIIb requires a right hepatectomy to achieve clear margins (the contralateral left hepatectomy is performed for Type IIIa). Confusion between IIIa and IIIb is common in MCQs.

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

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