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Percutaneous removal of biliary stone from anomalous right hepatic duct.

Intrahepatic biliaiy stone formation is prevalent in East Asia and there is a high frequency of retained intrahepatic stones after surgical treatment. The etiological factors include oriental cholangiohepatitis, parasitic infections and bile stasis. If the disease is isolated to one lobe orhepatic segment, surgical resection may be curative but when the disease is extensive, operative management includes a variety of complex drainage procedures. However, even after the biliary-enteric bypass surgery, symptoms often persist from residual stones and infection. Transcatheter interventional radiological techniques have been increasingly used in the management of a wide spectrum of biliaiy tract disorders. While percutaneous remoyal of common bile duct stones is relatively straight forwani, removal of intrahepatic stones is more complex and requires variable techniques. A case is presented here with anomalous insertion of right posterior intrahepatic duct into the cystic duct and having retained calculus. Percutaneous retrieval of stone was made possible by special technique described below.