Histological liver evaluation 5 years after surgery for extrahepatic biliary atresia: a study of 20 cases

Clinical, biological, and histological data are described in 20 patients at least 5 years after surgery for extrahepatic biliary atresia. Seventeen had an " uncorrectable " type and underwent hepatoportoenterostomy or hepatoportocholecystostomy , 3 patients had a "correctable" type and underwent cystojejunostomy . Clearing of jaundice was observed in all patients. Portal hypertension developed in 16 out of the 20. Liver specimens were obtained by surgical biopsy in all patients. Definite biliary cirrhosis was seen in all but two. Particular patterns were observed in some cases: biliary structures without bile stasis were absent in 8, while 4 displayed marked cell infiltration in portal areas, and 7 had distended vascular channels. The appearance of liver cells was always normal. No relationship could be clearly established between the degree of fibrosis and the earlier presence of cholangitis.