Abstract
Choledochal malformation (CM) may be defined as morphological abnormality of the biliary tract characterised by dilatation in the absence of acute mechanical obstruction. Bile duct maljunction with the incoming pancreatic duct and formation of a long common channel is a recognised element of CM. This allows free intermixing of pancreatic juice and bile, although the how dynamic this relationship is remains unknown. We have established that there is an inverse relationship of choledochal pressure and bile amylase (as a surrogate of reflux) and that the key component of damage to the biliary epithelium is pressure generated.
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