J Pediatr Surg 1984 Aug;19(4):467-70

In biliary atresia duct histology correlates with bile flow

Ohi R, Shikes RH, Stellin GP, Lilly JR

Abstract
Three basic types of microscopic biliary structures at the portahepatis were
distinguishable in infants with biliary atresia: bile ducts, collecting ductules
of biliary glands, and biliary glands. Correlation between the type of biliary
structure and the quantity and quality of post-operative bile flow was possible
in 23 instances. At 2 weeks after operation, the 11 patients in whom a bile duct
was identified had a daily bile flow of 68.0 +/- 11.5 mL. Bilirubin
concentration in the bile was 13.6 +/- 3.3 mg/dL and total daily bilirubin
excretion was 8.77 +/- 2.74 mg. In contrast, bile flow in 12 patients having
only collecting ductules and/or biliary glands in the porta hepatis was 19.1 +/-
3.9 mL and bilirubin concentration in bile was 1.7 +/- 0.3 mg/dL. Thus, total
daily bilirubin excretion was 0.34 +/- 0.08 mg (P less than 0.001).
Postoperative cholangitis occurred only in patients with ducts. It is concluded
that only bile ducts communicate with the intrahepatic biliary system and drain
bile after hepatic portoenterostomy