Abstract
A 74-year-old man was admitted to our hospital with right upper quadrant pain. Laboratory data on admission were as follows: aspartate transaminase (AST) 26 IU/L, alanine transaminase (ALT) 70 IU/L, total bilirubin 0.9 mg/dL, alkaline phosphatase 337 U/L, and γ-glutamyl transpeptidase 552 U/L. Magnetic resonance cholangiopancreatography (MRCP) revealed a trifurcated configuration of hepatic ducts with an unusual low union, and drainage of the cystic duct into the right posterior segmental duct, accompanied by several common bile duct (CBD) stones ([Fig. 1]). Endoscopic retrograde cholangiopancreatography (ERCP) revealed similar findings to those of the MRCP. The CBD stones were removed successfully using a retrieval basket after endoscopic sphincterotomy ([Fig. 2]). After 4 days, the patient underwent cholecystectomy followed by hepaticojejunostomy.
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