Current status of the biliary tract malformation

Abstract

The choledochal cyst (CC) can be better termed as biliary tract malformation because of the close association of embryology and etiology in the causation of CC. Contrary to Babbitt's postulation of reflux, damage and dilatation, reflux was not demonstrable as the causative factor in all varieties of CC. High pressure in the biliary system, otherwise termed ductal hypertension, is put forth as an alternative to explain the evolution of CC. The forme fruste type, which does not find a place in the standard classification, typifies the ductal hypertension hypothesis. Hence a closer, in-depth review would be able to highlight this apt terminology of biliary tract malformation.

Keywords: Choledochal cyst; Biliary tract; Biliary dilatation; Ductal hypertension; Common channel; Pancreatobiliary malunion

Core Tip: The biliary tract malformation has undergone a metamorphosis from its previous nomenclature of choledochal cyst owing to a variety of reasons. The etiology, embryopathology and the current classification require revisiting due to the same. The review looks at the same in detail.