J.Jpn. Surg. Soc.. 87(5): 547-557, 1986

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Original article

HISTOPATHOLOGICAL STUDIES ON CONGENITAL DILATATION OF THE BILE DUCT
－WITH SPECIAL REFERENCE TO THE REGURGITATION OF PANCREATIC JUICE INTO THE BILE DUCT－

Clinical and experimental studies on congenital dilataion of the bile duct (CDBD) were performed histologically as related to the regurgitation of pancreatic juice into the biliary tract. In all of the 40 patients, resected bile duct showed two characteristic findings such as grandular formation near the epithelial layfer with inflammatory cell infiltration and thickening of the wall occupied with increased collagen fibers.
Twenty two of 26 patients (84.6％) who had abdominal pain showed both findings and 11 of 15 cases (73.3％) who had jaundice showed only thickening of the wall (p＜0.01). Total bilirubin and alkaline phosphatase levels in serum were higher in latter patients and amylase level in bile was higher in the former (p＜0.05). Grandular formation was shown in all of the 9 patients of which bile duct dilated cylindrically.
A canine model in which total pancreatic juice passed via intact common bile duct was made in 10 mongrel dogs. Common bile duct showed cylindrical dilatation and grandular formation with inflammatory cell infiltration histologically.
In conclusion, regurgitation of pancreatic juice into the bile duct was thought to take part in grandular formation with inflammatory cell infiltration shown in CDBD.

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