Klatskin's tumor

Perihilar origin

Record the attributed site of origin separately from the full territory subsequently involved.

1. Where is the lesion's apparent origin relative to the right-left hepatic duct confluence and adjacent ducts? boundary
2. Which imaging, operative or pathology report supports that attribution, and with what certainty? provenance

Diagnostic basis

Preserve pathology results, clinical interpretation and unresolved alternatives as separate assertions.

1. Is the diagnosis suspected, clinically established or pathologically confirmed, and who made that determination? provenance
2. What evidence addresses inflammatory strictures, IgG4-related disease, stones or secondary involvement by another cancer? boundary
3. Was an inconclusive sample recorded as inconclusive rather than as proof of benign disease? definition

Longitudinal involvement

Keep the reported Bismuth-Corlette type alongside the anatomical observations from which it was assigned.

1. Which common hepatic, right, left and second-order ducts are involved or remain assessable as uninvolved? measurement
2. What ductal classification was assigned, and do anatomical variants or incomplete visualization limit it? boundary

Territorial feasibility

Record vascular relationships, lobar atrophy and proposed remnant assessments without automatically inferring operability.

1. Which portal vein and hepatic artery segments have suspected involvement, and what observation supports each assessment? measurement
2. For the proposed operation, what liver territory would remain and how were its volume, function and drainage assessed? action

Cholestasis and infection assessment

Track dated symptoms, laboratory findings and clinician assessments of suspected cholangitis.

1. What are the bilirubin trend, jaundice and pruritus burden before and after biliary interventions? measurement
2. Is cholangitis suspected or confirmed, and what documented escalation or treatment plan addresses it? action

Drained territories

Record which ducts each drain or stent serves, its current status and the specialist plan for reassessment.

1. Which liver territories are drained, remain obstructed or have uncertain communication with a drain? measurement
2. What was the intervention's intended purpose, and what evidence shows that purpose was achieved? action

Stage evidence

Perihilar staging includes local invasion, lymph nodes and distant spread. [NCI stages](https://www.cancer.gov/types/liver/bile-duct-cancer/stages)

1. What evidence supports each T, N and M assignment under the recorded staging edition? provenance
2. Which suspicious nodes or distant lesions remain indeterminate, and could resolving them change the proposed pathway? action

Specialist intervention review

BSG recommends specialist HPB discussion before perihilar endotherapy and describes transplantation for selected patients. Record the team's sampling, drainage and eligibility decisions. [BSG guideline](https://pmc.ncbi.nlm.nih.gov/articles/PMC10715509/)

1. Has the specialist team reviewed the proposed sampling route and drainage plan against possible resection or transplant pathways? action
2. What dated reasons support resection feasibility, transplant referral or a nonoperative pathway, including patient preferences? provenance
3. Which eligibility judgments depend on a named center's current protocol rather than a universal rule? boundary

Residual disease assessment

Link operative pathology or nonoperative response assessments to the original perihilar lesion.

1. After resection, what do the specimen report, ductal and radial margins, and examined nodes establish? provenance
2. After nonoperative treatment, what dated observations define the baseline for subsequent comparison? measurement

Recurrent obstruction interpretation

Record competing explanations for new hilar narrowing, laboratory changes or symptoms and the evidence resolving them.

1. Does new obstruction reflect suspected tumor recurrence, an anastomotic stricture, drain dysfunction or an unresolved combination? boundary
2. What corroborating evidence and specialist review support changing the recorded disease state or treatment plan? action

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Identifiers and schemes

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these identifiers and schemes hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Standards and regulation

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these standards and regulation hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Regional variation

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these regional variation hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of Klatskin's tumor this model covers, and on what evidence? provenance