In biliary atresia duct histology correlates with bile flow.
Three basic types of microscopic biliary structures at the portahepatis were distinguishable in infants with biliary atresia: bile ducts, collecting ductules of biliary glands, and biliary glands. Correlation between the type of biliary structure and the quantity and quality of post-operative bile flow was possible in 23 instances. At 2 weeks after operation, the 11 patients in whom a bile duct was identified had a daily bile flow of 68.0 +/- 11.5 mL. Bilirubin concentration in the bile was 13.6 +/- 3.3 mg/dL and total daily bilirubin excretion was 8.77 +/- 2.74 mg. In contrast, bile flow in 12 patients having only collecting ductules and/or biliary glands in the porta hepatis was 19.1 +/- 3.9 mL and bilirubin concentration in bile was 1.7 +/- 0.3 mg/dL. Thus, total daily bilirubin excretion was 0.34 +/- 0.08 mg (P less than 0.001). Postoperative cholangitis occurred only in patients with ducts. It is concluded that only bile ducts communicate with the intrahepatic biliary system and drain bile after hepatic portoenterostomy.
D001646:Bile / Q000378:metabolism*; D001652:Bile Ducts / Q000002:abnormalities* / Q000473:pathology; D002761:Cholangitis / Q000209:etiology; D004386:Duodenum / Q000601:surgery; D006801:Humans; D007223:Infant; D007583:Jejunum / Q000601:surgery; D008099:Liver / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications