An Experimental Study on the Etiology and the Pathogenesis in Congenital Dilatation of the Bile Duct

Abstract

The purpose of this paper is, 1) to clarify why there is no pathological dilatation of the bile duct in gouts in spite of their very long common channel, 2) to produce a model of congenital biliary dilatation in the gout, and 3) to clarify the etiology and the pathogenesis of congenital biliary dilatation. In the biochemical examination on the pancreatic and bile juice of man and gout, a marked difference was found in the composition of pancreatic juice between man and gout, and especially activity of the pancreatic enzymes was extremely lower in the gout. Therefore, administration of human pancreatic juice into the gallbladder of gout was performed using tube-cholecystostomy. Infant gouts within 1 month of age definitely showed cylindrical or spindle-shaped dilatation of the bile duct after infusion for about 4 weeks. But adult gouts showed no or only slight dilatation of the bile duct in the same period. As the pathogenesis of congenital dilatation of the bile duct, the effect of reflux of pancreatic juice into the bile duct was strongly suggested. Also it was suggested that the degree of dilatation of the bile duct may be determined at the intrauterine life or the early stage of life.