Study for bile duct dilatation of the choledochal cysts inferred from nerve plexus.

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1. This study analyzed the bile duct walls of patients with choledochal cyst as to whether the nerve fibers and nerve cells in the wall are abnormal or not. Bile ducts obtained from eight patients with choledochal cyst and three normal bile ducts without dilatation were studied Whole-mount preparations displaying the myenteric plexus running beneath the outer surface of the bile duct were made by removing the mucosa, submucosa, fibromuscular layers under a stereomicroscope. Whole-mount preparations were immersed in 0.3% Triton X-phosphate buffer solution for 2 to 3 days. They were immunohistochemically stained using the streptavidin-biotin-peroxidase method after 6- to 7-day incubation with anti-protein gene product (PGP) 9.5 antibody as the primary antibody.2. Developed networks of the myenteric plexus were observed in the fibromuscular layer near the outer surface. Distribution of the ganglia was clearly observed. Nerve strands of the patients were not significantly different from those of controls, but the number of ganglia of the patients decreased to one tenth of that of controls.3. This distribution of nerve strands and ganglia in the bile duct wall of choledochal cyst is similar to that in the intestinal wall of hypoganglionosis, which implies the mechanism of dilatation of the bile duct in patients with choledochal cyst is the same as that of megacolon in patients with hypoganglionosis.