Fresh autopsy specimens of 50 cases, 80 cases of cholelithiasis, 5 cases of biliary dyskinesia, 11 cases of cholelithiasis after gastrectomy and 5 cases of cancer of the gallbladder for a total 151 cases were studied in order to clarify the role of the autonomic nerve and content of catecholamine in the bile duct.
Section were collected from fresh autopsy specimens and various parts of the gallbladder were removed surgically.
The fluorescence histochemical method of Falck and Hillarp and acetylcholine esterase staining of Karnovsky were performed on the specimens to obtain results as follows.
1) The human gallbladder consisted sufficient sympathetic nerves and parasympathetic nerves and was composed of three plexuses.
2) The human common hepatic duct and common bile duct also consisted adrenergic fibres. The more abundantly they were distributed to the terminal part of the common bile duct.
3) Yellow cells considered as CCK-PZ like cells were observed in the mucous layer and smooth muscle layer of the gallbladder. This is the first time that they were observed by the use of the fluorescence technique.
4) Nerve cells in the ganglion of the human biliary duct system were accounted for in the main by the Dogiel II type.
5) The NA content in the tissue of the human bile duct was found to be greatest in the cystic duct and least in the common bile duct.
A difference in the mean value was observed with respect to the noradrenaline content in various diseases of the gallbladder.
6) The development of cholecystitis appears to involve mast cells for the acute phase and EC cells for the chronic phase. Further studies on this subject are under way.
7) In the biliary dyskinesia groups and the cholelithiasis groups following gastrectomy a pattern of hyperplasia was observed in each layer of the gallbladder for adrenergic fibres and a decrease in both true ChE and pseudo ChE was observed for cholinergic fibres.
Thus, it is suggested that the autonomic imbalance is responsible for the etiology of these diseases.
8) A difference was observed between the cholelithiasis groups and cholelithiasis groups following gastrectomy.
9) In the gallbladder cancer groups, adrenergic fibres were not observed in cancer lesions but hyperplasia was noted a little away from the lesions.
As for cholinergic fibres, abnormally thickened fibres were observed in the cancer lesions and likewise thickened fibres in the surrounding tissue.
However, we would rather refrain from drawing any conclusion on this subject owing to the small number of cases studied.
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