Intrahepatic stone in the caudate lobe treated by postoperative cholangioscopy: Report of a case

We report a 68-year-old female patient with intrahepatic stones in the right posterior inferior segment, the right anterior superior segment, and the caudate lobe. She had previously undergone distal gastrectomy, cholecystectomy, and choledochoduodenostomy. Advanced liver cirrhosis had been diagnosed at the previous laparotomy, and cholangioscopic lithotomy through a T-tube sinus tract was therefore performed. The stones in the right posterior inferior segment and the right anterior superior segment were easily extracted. However, removal of the stone in the caudate lobe was difficult and necessitated 11 sessions of cholangioscopy. Although reports of intrahepatic stones in the caudate lobe are unusual, modern diagnostic imaging modalities may identify more such cases.