Histologic study of biliary fibrous remnants in 48 cases of extrahepatic biliary atresia: correlation with postoperative bile flow restoration.

The fibrous remnants of bile ducts that were removed at surgery for extrahepatic biliary atresia were studied by serial section. Forty-eight specimens were classified into three types on the basis of histopathologic changes in the proximal portions of the speciments from the vicinity of the porta hepatis: (1) connective tissue without glands or other epithelial structures (15 cases); (2) connective tissue containing glands lined with cuboidal epithelium (15 cases); (3) connective tissue containing central biliary ducts and peripheral glands (18 cases). Histopathologic changes in sections from distal portions of the specimens did not conform to this classification. A precise correlation of prognostic significance could not be established between these histologic data and postoperative restoration of bile flow, although failure to restore flow was encountered most frequently in cases without demonstrable ducts or glands (TYPE 1).