Insights into the pathophysiology and classification of type 4 choledochal malformation

This study of 37 pediatric patients proposes subdividing type 4 choledochal malformations into cystic (4C) and fusiform (4F) subtypes based on distinct pathophysiological profiles. The cystic subtype presents with higher choledochal pressure and younger age, while the fusiform subtype shows elevated bile amylase and older presentation age.