A histopathologic study of the region of the ampulla of Vater in congenital biliary atresia.

A histopathologic investigation of the duodenal wall and adjacent tissues in the vicinity of the papilla of Vater was performed in 37 autopsied cases of congenital biliary atresia which were treated in the Department of Pediatric Surgery of the Juntendo University Hospital during the past 11 years. A high incidence of the association of a congentially abnormal junction of the common bile duct and pancreatic duct, that is, a long common channel and a poorly developed sphincter musculature, were found in congenital biliary atresia. This suggests the possibility that reflux of pancreatic juice into the biliary system, followed by nonsuppurative chronic inflammation of bile ducts, may ultimately lead to the obstructive cholangiopathy seen in biliary atresia.