Histological study of the remnant of porta hepatis in patients with extrahepatic biliary atresia - A computed picture analysis of 30 cases.

The fibrous remnants of porta hepatis at the level of hepatic portoenterostomy for extrahepatic biliary atresia were examined histologically, and the number of bile ductules calculated, the area of the largest bile ductule and total area of all bile ductules was estimated in 30 cases, using a computed picture analyzer. Although there was no correlation between the degree of postoperative bile drainage and the number of ductules or the area of the largest bile ductule , the total area of all bile ductules in cases of adequate bile drainage (100,500 +/- 9,900 mu2, mean +/- SEM, n = 13) was significantly larger than that of those with poor bile drainage (29,900 +/- 9,900 mu2, n = 7) (p less than 0.05). More effective bile flow was evident in those with over 50,000 mu2 of a total area of bile ductules, compared to those with less than 50,000 mu2. However, in 4 there was a good postoperative bile drainage, despite a small area of all bile ductules of the porta hepatis. Thus, the total area of all bile ductules rather than the number at the porta hepatis or an area of the largest bile ductule , seems to be an important factor relating to a better postoperative bile drainage in extrahepatic biliary atresia.