title: Hypogenesis of intramural vascularity and perivascular plexuses of gallbladder in patients with congenital biliary dilatation.
abstract: BACKGROUND
  We hypothesized neuronal disorders of the biliary tract as the cause of congenital biliary dilation (CBD).
  
  
  METHODS
  Gallbladders were removed from a total of 15 patients who were categorized into two study groups: a CBD group (eight patients) and in a control group (neuroblastoma, acute myelogenous leukemia, wandering gallbladder, Wilms' tumor, glycogen storage disease, familial amyloid polyneuropathy; seven patients). Whole-mount preparations of the gallbladders were made to immunostain the intramural nerves.
  
  
  RESULTS
  The intramural vascularity in the gallbladders of the CBD group (5.5 +/- 1.9/cm(2)) was significantly lower than that in the control group (27.6 +/- 14.4/cm(2)). The rate of perivascular plexuses on the surface of intramural vessels was also significantly lower in the CBD group than in the controls (37.7 +/- 18.1 vs. 80.2 +/- 17.4%, respectively). The numbers of ganglion cells per visual field were 38.5 +/- 24.0 and 42.3 +/- 20.6, respectively, in the CBD and control groups; this difference was not statistically significant.
  
  
  CONCLUSIONS
  There may be a mechanism in CBD causing contractile failure and dilatation of the biliary tract as a result of decreased intramural blood flow that accompanies the diminished vascularity.
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8560, Japan. skatsuno@aichi-med-u.ac.jp
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Katsuno
authors.forename: Hisami
authors.initials: H
authors.lastname: Ando
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Toru
authors.initials: T
authors.lastname: Harada
authors.forename: Takahiko
authors.initials: T
authors.lastname: Seo
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic / Q000151:congenital / Q000473:pathology; D005260:Female; D005704:Gallbladder / Q000098:blood supply* / Q000294:innervation*; D005705:Gallbladder Diseases / Q000151:congenital* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D009415:Nerve Net / Q000473:pathology*; D009475:Neurons, Afferent; D011336:Probability; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric