Abstract
A 30-year-old man was admitted to the hospital because of epigastralgia and jaundice. Abdominal ultrasound examination and computed tomography revealed dilated intrahepatic bile ducts in the right posterior and left medial segments. ERCP radiographs showed anomalous biliary anatomy with the right posterior segmental duct inserting into the right anterior segmental duct. In addition, the latter was drained into the left lateral duct. A right posterior segmentectomy and a left medial segmentectomy were conducted. No bilioenteric anastomosis was placed. The patient was discharged on the 21st postoperative day. The general rules for the treatment of hepatolothiasis are to remove calculi completely and to relieve bile stagnation. This case highlights the importance of an awareness of biliary tract anomaly and the necessity of appropriate treatment for hepatolithiasis with anomalous anatomy where a hepatecotmy sholud be employed by making the most use of intraoperative US and cholangioscopy, if it can be a radical operation.
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