乳児期閉塞性黄疸疾患と胆管膵管合流異常に関する研究 : 特に合流形態と膵液の胆道系への逆流について

概要

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The purpose of this paper is to describe the congenital abnormal junction of the common bile and pancreatic ducts which caused the infantile obstructive cholangiopathy. Studies were done on both normal junction of the common bile and pancreatic ducts and the influence of the pancreatic juice refluxed into the biliary system. A histopathological investigation on the junction of the common bile and pancreatic ducts was performed in 67 autopsy cases, all of these had no hepato-biliary and pancreatic lesion. The normal junction is existing within or/and under the mucosa of the papilla of Vater and the average length of the common channel of the common bile and pancreatic ducts is 1.06 mm. It seems that the abnormal junction of the common bile and pancreatic ducts is existing at exterior to the tunica muscularis propria of the duodenum. In addition, the length of the common channel is extremely long. If there is the anatomical abnormality, namely the abnormal junction of the common bile and pancreatic ducts, the pancreatic juice refluxes easily into the biliary system and then if the bile stasis by the stenosis of the common bile duct exists, the refluxed pancreatic juice causes a histopathological changes in the biliary system. This study suggests that the existence of the stenosis of the biliary system and of the common bile and pancreatic ducts is essential for the origin of the dilatation of common bile duct.
日本小児外科学会の論文