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August 1988

Choledochal Cysts: Oligoganglionosis in the Narrow Portion of the Choledochus

Author Affiliations

From the Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan (Drs Kusunoki, Yamamura, Fujita, Takahashi, and Utsunomiya), and the Department of Pharmacology, Kobe (Japan) University School of Medicine (Dr Saitoh).

Arch Surg. 1988;123(8):984-986. doi:10.1001/archsurg.1988.01400320070014

• To investigate whether cystic dilation may be due to a reduction of postcholinergic cell bodies that leads to autonomic dysfunction, ganglion cell bodies were counted in five patients with choledochal cysts and five patients with normal choledochus. In the normal choledochus, the ganglion cell counts in the proximal and distal portions were 374.7±82.7/cm2 and 349.2 ±51.2/cm2, respectively. In cases of choledochal cysts, the ganglion cell counts in the dilated portion and narrow portions were 298.6 ±86.9/cm2 and 81.0±34.8/cm2, respectively. The cell ratio (narrow to dilated) was 0.271. Significant reductions of cell numbers were observed in all the choledochal cysts having various types of pancreatobiliary junctions. These findings indicate that the reduction in the number of ganglion cells in the narrow portion of the choledochal cyst supports the concept of oligoganglionosis in distal choledochus.

(Arch Surg 1988;123:984-986)

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