Electron microscopic studies in biliary atresia. I. Bile ductular proliferation.

Abstract

BILE ductular proliferation is a prominent feature of extrahepatic biliary atresia, even with intrahepatic biliary hypoplasia. 1-5 Bile ductules, the small channels connecting the bile ducts in the portal tracts with the canaliculi between the liver cells, occasionally are difficult to recognize with the light microscope because the clusters of cells are irregular and hidden by the associated periductular inflammatory cell infiltration. Electron microscopy, which helped establish the nature of the cells, is well suited for their study. 6 The ductular cell reaction, or ductular cell proliferation together with the inflammatory cell infiltration, 7 has been linked to hepatic fibrogenesis and cirrhosis. Children with biliary atresia develop biliary cirrhosis rapidly; with progressive disability. The electron microscopic examination of the ductular cells in atresia was undertaken for the following reasons: (1) to study the nature of these proliferating cells in the absence of bile flow and their functional significance, and (2)