1988 Volume 34 Issue 3 Pages 357-369
Clinical and experimental studies were performed in order to clarify the pathogenesis of bile duct carcinoma and its occurrence in cases of Abnormal Pancreatico-Choledocho-Ductal Junction (APCDJ). Operative specimens of the gallbladder and common bile duct were studied histopathologically in thirty-nine children with congenital biliary dilatation associated with APCDJ. As a result, metaplasia was observed in the gallbladder of five patients and in the bile duct of seven. In addition, hyperplasia occurred in ten patients and dysplasia in the remaining one. Fewer histological changs were observed in children as compared to adults patients. As an experimental animal model of APCDJ, choledocho-pancreatico end to side anastomosis was performed in seven mature dogs and ninty-nine puppies. Histopathological studies of the biliary tract revealed that as the postoperative period became longer, metaplasia and hyperplasia likewise became more prominent. Furthermore, among nine dogs which were sacrificed at five years earlier, papillomatous adenoma occurred in four dogs and biliary stones were found in seven dogs. Cell Kinetics in biliary tract mucosa observed by the use of a monoclonal antibody against bromodeoxyuridine (BrdU) was obviously elevated in the dogs subjected to the long-term follow up. These processes of histological changes in biliary epithelium of clinical and experimental material suggested the possibility of the occurrence of bile duct carcinoma due to the pancreatic juice reflux into the bile duct in cases of APCDJ.
