Choledochal malformations: global research, scientific advances and key controversies

  • Florian Friedmacher
  • Kathryn E. Ford
  • Mark Davenport
Review Article


Choledochal malformations (CMs) represent a spectrum of relatively rare and complex congenital anomalies, characterized by abnormal dilatation of the biliary tract in the absence of any acute obstruction. Today, almost 20% of CMs can be detected in-utero using maternal ultrasonography. Formal scientometric analysis was used to identify where modern CM research is taking place and perhaps where our attention should be directed in the future. Thus, this article offers a comprehensive review of recent scientific advances relating to CMs including the current understanding of etiology and classification, whilst also discussing key controversies such as risk of malignant transformation and the role of newer modalities of surgical treatment. Although laparoscopic excision of CMs and biliary reconstruction is nowadays feasible and safe, care should be taken before dispensing with standard open techniques, which have minimal complication rates and proven long-term benefit.


Choledochal cyst Choledochal malformation Choledochal diverticulum Choledochocele Bile duct Biliary tract 



The authors thank the medical staff librarians at the Weston Education Centre Library of King’s College London for their outstanding support in the literature search process for this manuscript.


No external funding was received by any of the authors in support of this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This review article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study informed consent was not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryKing’s College HospitalLondonUK
  2. 2.Department of Pediatric SurgeryThe Royal London HospitalLondonUK
  3. 3.Department of Pediatric SurgeryOxford University HospitalsOxfordUK

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