Scotto J M, Stralin H G
Arch Pathol Lab Med. 1977 Aug;101(8):416-9.
Ten cases of congenital extrahepatic biliary atresia were studied ultrastructurally. Samples of liver were obtained from each and in six of the cases, fibrous tracts, which we hoped would contain extrahepatic bile ducts, were also secured. The observed extrahepatic biliary structures were real, but hypoplastic, bile ducts. In places, necrosed epithelial cells, without obvious inflammatory processes, could be observed. The ductular cell cytoplasmic changes and the inflammatory reaction are different according to whether extrahepatic or intrahepatic sites are considered. These differences, as well as the cytoplasmic modifications of liver parenchymal cells, seem to be the result of impaired bile flow. On the contrary, extrahepatic bile duct hypoplasia and necrosis seem to be directly related to the unknown origin of this disease. Whether the nuclear changes of hepatocytes are the expression of direct injury of the liver is another important question. If there is direct injury, it is possible that the disease might evolve as an independent liver disease despite a correctly performed and uncomplicated surgical intervention.
对10例先天性肝外胆道闭锁病例进行了超微结构研究。从每例获取肝脏样本，其中6例还获取了我们希望含有肝外胆管的纤维束。观察到的肝外胆道结构是真实的，但为发育不全的胆管。在某些部位，可以观察到坏死的上皮细胞，且无明显炎症过程。根据是考虑肝外还是肝内部位，小胆管细胞的细胞质变化和炎症反应有所不同。这些差异以及肝实质细胞的细胞质改变似乎是胆汁流动受损的结果。相反，肝外胆管发育不全和坏死似乎与该疾病的未知起源直接相关。肝细胞的核变化是否是肝脏直接损伤的表现是另一个重要问题。如果存在直接损伤，那么尽管手术操作正确且未出现并发症，该疾病仍有可能发展为一种独立的肝脏疾病。
