S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) The Seoul Journal of Medicine The Seoul Journal of Medicine Vol. 27 No.4 (1986)
Congenital Biliary Atresia A Histological Analysis of 40 Operated Cases
선천성 간외담관폐쇄의 병리조직학적 관찰
- Chi, Je G.; Kim, Chul Woo; Kim, Woo Ki; Park, Kwi Won
- Issue Date
- Seoul J Med, Vol.27 No.4, pp. 319-328
- Based on 40 cases of biliary atresia that were operated for portoenterostomy
histopathological analysis was carried out with special reference on liver changes. Seven cases
of neonatal hepatitis and 6 cases of choledochal cyst were included in the materials to
elucidate the differentiating characteristics among them.
The liver in biliary atresia showed a wide range of pathological features from minimal triaditis
to advanced cirrhosis. To quantitate the degree of progressive widening of portal tracts, bile
duct proliferation index was calculated to show a significant difference among cases of biliary
atresia, neonatal hepatitis and choledochal cyst.
Histopathological changes of extrahepatic biliary tree in biliary atresia were characterized by
fibrosing inflammation with productive fibrosis involving entire biliary system. The findings were
more pronounced in proximal portion than in distal portion, thus suggesting inflammation-fibrosis
sequence in a proximal-to-distal direction.
The patient age at the time of operation and the size of bile duct in proximal most portion of
hepatic duct appeared the to be two most important factors in determining the long term survival
after operation. Bile ducts larger than 200 f1 m in diameter seemd to be an important indicator
for better prognosis. Hepatitis B seropositivity was present in 9 of 19 cases of biliary atresia
that were examined. However, none of the livers that were stained with anti-HBsAg and
anti-HBcAg was positive in immunohistochemical stains.