肝外胆道闭锁肝内胆管的三维构形变化──检测预后的一种依据

目的：通过肝内胆管三维结构重建，预测肝外胆道闭锁的预后。方法：对２例肝外胆道闭锁和１例对照的肝组织进行二维病理观察。系列组织切片在计算机辅助下，重建肝内胆管的三维构形。结果：二维病理学研究显示，胆道闭锁、肝内胆管增生、炎症和肝组织纤维化明显。胆道闭锁２例的肝内胆管三维构形是相似的，小叶间胆管弯曲扩张并形成微囊肿；增生的胆管主要来自赫令管，多数赫令管管腔开放并且互相连结形成网络状，少数赫令管形成膨大盲端。结论：①肝外胆管闭锁的三维构形变化是检测预后的依据之一；②小叶间胆管的微囊肿和赫令管膨大盲端，指示肝外胆道闭锁不适合肝肠吻合术而需要肝移植治疗

Study on three dimensional patterns of intrahepatic bile duct in extrahepatic biliary atresiaOne of bases for determining prognosis

Objective:This article was to determine prognosis of extrahepatic biliary atresia by three dimensional pattern of intrahepatic bile ducts.Methods:Liver tissues of 2 cases of extrahepatic biliary atresia and a control case were observed.Three dimensional pattern of intrahepatic bile ducts were reconstructed from serial sections by the aid of computer.Results:Two dimensional pathology showed liver changes,including obvious proliferation of bile ducts,inflammation and fibroses of liver.Three dimensional patterns were similar in two cases of extrahepatic biliary atresia,interlobular bile ducts were curved and expansive,and formed micro cysts;proliferative bile ducts came from Herring canals which was mostly open and connected each other forming networks;a few Herring canals formed expanding cupular cecum.Conclusion:①Reconstruction of three dimensional patterns of intrahepatic bile duct are one of bases for determining prognosis of extrahepatic biliary atresia.②The microcysts of intelobular bile ducts and expanding cupular cecum of Herring canals indicate unfavorable prognosis of extrahepatic biliary atresia and it is necessary for the disease to be given liver transplatation.