Introduction In the previous paper on the peculiarities of cholelithiasis in the Japanese, T. Maki,1 one of the authors, stated that the intrahepatic gallstones in the Japanese are mostly pigmented calcium stones and may not be formed independently of the common duct stone but rather under the same pathogenesis as the choledocholithiasis. Therefore, it is natural that the incidence of these intrahepatic calculi is much higher in Japan than in Western countries. It is estimated to be 5% to 15% of all gallstone cases in Japan,2 while it seems to be 5% to 8% at most in Western countries.3,4 We have had 20 cases of intrahepatic calculi, which were about 7% of all the gallstone cases experienced. Of these 20 cases, a 54-year-old male, an autopsy case, was the only one having cholesterol stones, the stones in this case lodging at the bifurcation of the intrahepatic main