American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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What characteristic distinguishes type 3b cholangiocarcinoma?

  1. Involves the hilum and left hepatic duct

  2. Involves only the common bile duct

  3. Involves the hilum and right hepatic duct

  4. Involves the hilum and left hepatic duct

The correct answer is: Involves the hilum and right hepatic duct

Type 3b cholangiocarcinoma is characterized by its involvement of the hilum and the right hepatic duct. This type of cholangiocarcinoma is known for creating a more extensive and aggressive tumor that typically presents at the junction of both the right and left bile ducts, significantly affecting biliary drainage and potentially leading to obstructive jaundice. This involvement is crucial in terms of surgical management and prognosis. When the right hepatic duct is affected, it indicates that the tumor has a larger extent of growth, necessitating more complex surgical interventions such as more extensive resections or liver transplantation, depending on the extent of the disease and the patient's overall health. The options referring to only the common bile duct or the involvement of the hilum with the left hepatic duct do not account for the specific anatomical relationship and dissemination of type 3b cholangiocarcinoma as well as the correct option does, highlighting the unique nature of its invasive characteristics.

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