Successful separation of a conjoined biliary tract in a set of omphalopagus twins

Omphalopagus twins were separated in the first 48 hours of life. Preoperative evaluation did not disclose either their conjoined intestines or their conjoined biliary tract; intraoperative evaluation, including an operative cholangiogram, was required to determine if separation was possible. The intestines were divided to give each infant an equal share, and an hepaticoenterostomy was constructed in each of the twins.