Treatment outcomes for patients with Bismuth–Corlette type IV portal cholangiocarcinoma

Aim . To evaluate the treatment outcomes for patients with true type IV portal cholangiocarcinoma according to the Bismuth–Corlette classification. Materials and methods . The study involved the treatment outcomes of 272 patients with portal cholangiocarcinoma for 2014–2022. Bismuth–Corlette type IV tumors were initially diagnosed in 59 patients. Results . Upon assessing the anatomy of bile duct confluence using MRI and cholangiography, Bismuth–Corlette type IV tumors were verified in only 22 patients. In other cases, the extent of the tumor process was overestimated due to different anatomical configurations of the duct confluence. Seven patients (33%) underwent surgery, with R0 resection performed in four of them. The median survival after radical surgery accounted for 12 months (8–23 months), while in the palliative group without chemotherapy, it amounted to 3 months (2–12 months), and with chemotherapy – 10 months (3–34 months). Conclusion . Radical surgical intervention can be performed in one-third of patients with proven Bismuth–Corlette type IV portal cholangiocarcinoma. A comprehensive multidisciplinary approach to treatment enhances the survival duration of palliative patients with portal cholangiocarcinoma.