Ectopic papilla of vater in biliary atresia

Abstract

Objective The etiology for biliary atresia (BA)is still unkown. The aims of this study was to investigate the relationship between the size and location of pancreaticobiliary ducts and biliary atresia. Methods this study was carried out in 47 patients with biliary atresia who had cholan- giography. Twenty-nine neonates with persistent jaundice were used as controls. In order to excluded variations in magnification and age between studies, Length index (the ratio of the common channel length to the height of the second lumbar vertebra) was adopted to eliminate the age factor. Results In the control group,24.1% (7/29)the papilla of Vater was located distal to second portion of the duode- num,however 51.1% (24/47) of the patients with biliary atresia had the papilla of Vater distal to the second portion of the duodenum. The ratio of ectopic papilla of Vater was significantly higher in BA patients than in controls (P 0.05. The length indices of the common channel in BA and control groups were 0.418 ± 0.152 and 0.236 ± 0.122 respectively, the former was significantly longer than in latter (P<0.05). The average diameter of the common bile duct in BA was significantly smaller than in con- trol (0.078 ± 0.043 versus 0.199 ± 0.086, P<0.05). Conclusions The high incidence of ectopic papil- la of Vater and the longer common channel in BA patients suggest that over-growth of the hepatic di- verticulum during early embryonic development may be an important etiologic factor for BA. Key words: Biliary atresia; Cholangiography