The excellent review of congenital malformations of the bile ducts by J. B. Holmes1 in 1916 stimulated interest in the surgical correction of these conditions. He analyzed 120 reports which had appeared in the literature and concluded that a successful operation was theoretically possible in about 16 per cent of all cases. Accordingly, early exploration was strongly advised and is now generally practiced.
The clinical manifestations of this disorder have been described adequately in the many articles on the subject and in all textbooks on pediatrics. Jaundice in the newly born appears most commonly as a result of icterus neonatorum and erythroblastosis fetalis. Syphilis and sepsis are less frequent causes. A few instances of cholelithiasis in this age group have been reported. Biliary obstruction due to inspissated bile or mucus is often associated with a congenital stenosis of the bile ducts. Successful treatment by simple probing of the ducts