caa a22 4500 465772390 CHVBK 20180323111932.0 cr unu---uuuuu 170327e19900601xx s 000 0 eng 10.1007/BF00169665 doi (NATIONALLICENCE)springer-10.1007/BF00169665 Experimental hepatoportoenterostomy: duct mucosal healing with hybrid biliary-intestinal epithelium forming an autoanastomosis [Elektronische Daten] [Robert Touloukian, Kenneth Barwick, Bernard Vasseur, Nancy Rosenfield, Paul Hoffer] Permanent bile flow following hepatoportoenterostomy for biliary atresia is presumed to follow mucosal healing of the biliary tract to the intestinal epithelium, but the morphology of the anastomosis and the histology of the neo-biliary duct is not known. Experimental portoenterostomies were constructed in five normal 10-kg mini-pigs at approximately 3 months of age to study the healing of the anastomosis. The extrahepatic bile duct was resected in continuity with an en-bloc 1.5 × 0.3-cm segment of liver at the porta hepatis and biliary drainage was achieved with a Roux-en-Y jejunal limb. The bile duct remnant at the porta hepatis measured 3 mm in diameter. HIDA scan performed at 2 months showed prompt excretion of the radioisotope and normal function of the jejunal limb. Animals were killed at 2 weeks, 1 month, and 3 months following operation and the intact hepatobiliary anastomosis examined by routine histology and histochemical staining for acid and neutral mucins. At 2 weeks the biliary epithelial ducts were hyperplastic and showed evidence of cellular regeneration and cholangitis. By 1 month the biliary and intestinal epithelia were in close approximation. At 3 months the biliary-intestinal epithelium was healed, forming a funnel-like autoanastomosis with normal proximal biliary epithelium and distal intestinal epithelium. An intervening zone of hybrid biliary-intestinal epithelium showed basal crypts with characteristics of biliary epithelium, while the superficial glandular epithelium resembled intestinal villi. Mucin histochemistry of the hybrid epithelial lining revealed predominantly neutral mucins in the basal region of the mucosa characteristic of biliary mucosa. The luminal epithelium revealed a high acid mucin content, including goblet cells. A microvillus brush border, rich in neutral mucin, was also present apically on the luminal most cells. We conclude that: (1) hepatoportoenterostomy in normal mini-pigs is a reproducible model to study healing of the anastomosis; (2) a continuous, intact hepatobiliary-intestinal mucosa is present within 3 months following portoenterostomy; and (3) the neo-epithelium has a hybrid biliary-intestinal appearance. This study may have application to understanding the cause of cholangitis following portoenterostomy for biliary atresia. Springer-Verlag, 1990 Biliary atresia nationallicence Extrahepatic biliary atresia nationallicence Hepatoportoenterostomy nationallicence Touloukian Robert Section of Pediatric Surgery, Yale University School of Medicine, 06510, New Haven, CT, USA aut Barwick Kenneth Department of Imaging and Pathology, Yale University School of Medicine, 06510, New Haven, CT, USA aut Vasseur Bernard Section of Pediatric Surgery, Yale University School of Medicine, 06510, New Haven, CT, USA aut Rosenfield Nancy Department of Diagnostic, Yale University School of Medicine, 06510, New Haven, CT, USA aut Hoffer Paul Department of Diagnostic, Yale University School of Medicine, 06510, New Haven, CT, USA aut Pediatric Surgery International Springer-Verlag 5/4(1990-06-01), 255-259 0179-0358 5:4<255 1990 5 383 https://doi.org/10.1007/BF00169665 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00169665 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Touloukian Robert Section of Pediatric Surgery, Yale University School of Medicine, 06510, New Haven, CT, USA aut NATIONALLICENCE 700 1- Barwick Kenneth Department of Imaging and Pathology, Yale University School of Medicine, 06510, New Haven, CT, USA aut NATIONALLICENCE 700 1- Vasseur Bernard Section of Pediatric Surgery, Yale University School of Medicine, 06510, New Haven, CT, USA aut NATIONALLICENCE 700 1- Rosenfield Nancy Department of Diagnostic, Yale University School of Medicine, 06510, New Haven, CT, USA aut NATIONALLICENCE 700 1- Hoffer Paul Department of Diagnostic, Yale University School of Medicine, 06510, New Haven, CT, USA aut NATIONALLICENCE 773 0- Pediatric Surgery International Springer-Verlag 5/4(1990-06-01), 255-259 0179-0358 5:4<255 1990 5 383 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer