Perihilar Bile Ducts
87
Perihilar Bile Ducts (ICD‐O‐3 C24.0) Rules for Classification The classification applies to carcinomas of the extrahepatic bile ducts of perihilar localization (Klatskin tumour). Included are the right, left and the common hepatic ducts. The following are the procedures for assessing T, N, and M categories. T categories Physical examination, imaging, and/or surgical exploration N categories Physical examination, imaging, and/or surgical exploration M categories Physical examination, imaging, and/or surgical exploration
Anatomical Sites and Subsites
Regional Lymph Nodes The regional nodes are the hilar and pericholedochal nodes in the hepatoduodenal ligament.
TNM Clinical Classification T – Primary Tumour TX Primary tumour cannot be assessed T0 No evidence of primary tumour Tis Carcinoma in situ
T1 Tumour confined to the bile duct, with extension up to the muscle layer or fibrous tissue T2a Tumour invades beyond the wall of the bile duct to surrounding adi pose tissue T2b Tumour invades adjacent hepatic parenchyma T3 Tumour invades unilateral branches of the portal vein or hepatic artery T4 Tumour invades the main portal vein or its branches bilaterally; or the common hepatic artery; or unilateral second‐order biliary radi cals with contralateral portal vein or hepatic artery involvement
Digestive System
Perihilar cholangiocarcinomas are tumours located in the extrahepatic biliary tree proximal to the origin of the cystic duct.