Posterior Right Disconnected Bile Duct

A 50-year-old woman was referred to our tertiary Hepato-Pancreato-Biliary (HPB) Surgery Center two years after undergoing a complex cholecystectomy (Mirizzi Syndrome Type 2) with T-Tube placement in the common bile duct after an episode of mild cholangitis. Cross-sectional imaging revealed sectoral dilatation of the right posterior bile duct. Focal intrahepatic strictures often present with vague symptoms such as fever, jaundice, or abdominal pain. A differential diagnosis based on the patient’s clinical history and basic imaging data should take into consideration iatrogenic and non-iatrogenic causes of segmental cholangiectasia. Given the difficulty in ruling out malignancy (which occurs in 50–70% of the cases of isolated cholangiectasia) a liver resection should be considered, since it can provide both the data necessary for a definitive diagnosis allowing an oncologically correct treatment plan.