Abstract
Fig. 1 illustrates the current concept in classifying choledochal malformation. Essentially the three commonest variants are type 1c – the classical choledochal cyst; type 1f – a fusiform dilatation of the extrahepatic biliary tract; and type 4 – either of the foregoing with significant dilatation of the intrahepatic bile ducts. Most of these types also have a definable common pancreatobiliary channel, that can dilate and become filled with debris or stones. These children usually present with pancreatitis.
Anatomical imaging is important in the workup and a detailed magnetic resonance cholangiopancreatography ([MRCP] is a minimum requirement ideally showing a common channel and intrahepatic ducts) may prevent the need for formal cholangiography on-table.