胆管癌分期（英文）.pdfVIP

Staging Systems Many staging systems have been proposed for hilar cholangiocarcinoma and none of them has been accepted unanimously. Three different types of classification have been suggested: – Classification based on macroscopic biliary involvement (Bismuth-Corlette) – Histopathologic classification (TNM AJCC/UICC and Japanese Society for Biliary Surgery, JSBS) – Classification based on biliary and vascular involvement (Gazzaniga and Memorial Sloan Kettering Cancer Center, MSKCC) Bismuth-Corlette Classification Bismuth-Corlette classification was introduced in 1975 and modified in 1992; it classifies lesions according to biliary longitudinal extent (Table 1) [1,2] into dif- ferent anatomical groups based on radiological and operative findings (Fig. 1). Fig. 1 Modified Bismuth-Corlette classifica- tion of the longitudinal extent of hilar cholan- giocarcinoma (see also Table 1) A. Guglielmi, A. Ruzzenente, C. Iacono (eds.) Surgical Treatment of Hilar and ICC. © Springer 2008 87 88 Surgical Treatment of Hilar and Intrahepatic Cholangiocarcinoma Table 1 Bismuth-Corlette classification [1] Type I Neoplasm arises near the biliary confluence without involvement of the left and right biliary ducts Type II Neoplasm arises at the biliary confluence with extension to left and right ducts Type IIIa Neoplasm arises at the biliary confluence with extension to the right hepatic duct up to the second order ducts Type IIIb Neoplasm arises at the biliary confluence with extension to left biliary duct up to the second order ducts Type IV Neoplasm arises at the biliary confluence with bilateral ex