Histological study of the choledochal cyst wall.

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Most literature states that choledochal cysts lack muscles and mucosa and dose not mention the presence of a muscles in the wall of the lower portion of the choledochal cyst and in the narrow portion which lies in the pancreatic tissue. The present studies were made in order to determine whether or not smooth muscle may exist as a structural component of the wall.Specimens were obtained at laparotomy from 9 patients with choledochal cyst. These specimens were examined microscopically and the thickness of the smooth muscle bundles and mucosal layer was measured with a micrometer.Numerous smooth muscle bundles were found in the lower part of the choledochal cyst wall. Longitudinal and circular muscles formed a layer around the wall of the duct. Longitudinal muscle bundles had 3 to 8 layers and were 10 to 50μ thick. Circular muscle bundles had 1 to 9 layers and were 60 to 250μ thick. Muscle layers were 0.7 to 1.6mm in thickness and were localized 6 to 25mm in length. In 7 patients, the lower protion of the choledochal cyst wall exibited tall columnar epithelium 0.2 to 0.7mm in height and 2 to 20mm in length. On the other hand, there was no distinct muscle layer and short columnar epithelium was present in the narrow portion.
財団法人日本消化器病学会の論文