Abstract
The area of papilla of Vater including the pancreaticobiliary duct junction site was histologically investigated by serial sections in 15 autopsy cases of biliary atresia (BA). Fifteen human fetuses aged 12 to 28 gestational weeks and autopsy materials of 25 infants and 30 adults without pancreaticobiliary diseases were similarly investigated as controls. The length of the common pancreaticobiliary channel was 6.3 ± 1.5 mm in 7 BA cases, in which both the pancreatic and bite ducts were present in the papilla of Vater, and it was significantly (p<0.01) longer than that in infant and adult controls. In all 7 cases, the pancreaticobiliary junction site was located near the region where both the bile and pancreatic ducts penetrated the duodenal wall. In the other 8 BA cases, in which the bile ducts were absent in the papilla of Vater, it was histologically supposed that the bile ducts were secondarily disappeared near the outer duodenal wall. The length from the duodenal orifice in the major duodenal papilla to the outer duodenal wall, i.e., nearly the length of the papilla of Vater, was significantly longer (p<0.05) in the 15 BA cases than in normal infant controls. These results indicated that BA has a long pancreaticobiliary common channel and there is much possibility of the same etiology in either BA or CBD. It was thus suggested that pancreaticobiliary maljunction is etiologically responsible not only for CBD but also BA.
