Surgical strategy for bile duct cancer: Advances and current limitations

Figure 1 Anatomic classification of cholangiocarcinoma. A: The majority of cholangiocarcinoma (60%-70%) develop in the hilar bile duct and are called Klatskin tumors. The distal bile duct is involved in 20% to 30% of cases, while intrahepatic cholangiocarcinomas represent 5% to 10% of the tumors originating from the biliary tract; B: Bismuth-Corlette classification of hilar bile duct cancer. Type I, cholangiocarcinoma confined to the common bile duct; Type II, cholangiocarcinoma involves the bifurcation of the common bile duct; Type IIIa, cholangiocarcinoma involves the bifurcation and the right hepatic duct; Type IIIb, cholangiocarcinoma involves the bifurcation and the left hepatic duct; Type IV, cholangiocarcinoma involves the bifurcation and extends to both the right and left hepatic ducts.

Figure 2 Hilar cholangiocarcinoma (Bismuth-Corlette type IIIa). Comprehensive multiphase fusion images of the tumor (orange), bile duct (green), and surrounding vessels including hepatic artery (red), portal vein (light yellow), and hepatic vein (blue).