Variant intrahepatic bile duct anatomy such as the right posterior hepatic duct draining the common hepatic duct or into the cystic duct are examples which can have increased risk of inadvertent clipping/occlusion at the time of cholecystectomy. The operative note was reviewed and no such anatomical variant was noted.

However, it is quite apparent that the dilated intrahepatic ducts draining segments six and seven (which is the right posterior hepatic duct) lead into cholecystectomy clips without evidence of mass. There is relative atrophy of hepatic segments six and seven. This makes chronic obstruction of these ducts due to inadvertent clipping at the time of cholecystectomy the most likely and logical explanation of these findings.