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Introduction: Choledochal cyst is a cystic dilation of the biliary tree. It is not a true cyst but a developmental defect occurring in 1 in 100,000 to 150,000 live births in the Western hemisphere and in 1 in 1000 live births in Asia, especially Japan. It is often associated with other defects in the biliary tree such as anomalous pancreaticobiliary junction, duplication of gallbladder or common bile duct, absent gallbladder, stenoses of intrahepatic bile ducts, and annular pancreas.

Pathogenesis: Maljunction of pancreaticobiliary ductal system is thought to play a role. The junction of pancreatic and bile ducts outside the duodenal wall results in formation of an extremely long common channel, allowing pancreatic enzymes to regurgitate into the bile.

This photograph shows an opened choledochal cyst on the right and a small gallbladder on the left. Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; image cropped from the original and used with permission.
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