Pathological changes
and significance of intrahepatic peribiliary glands, hitherto poorly recognized
intrahepatic elements, have been evaluated in our laboratory. In this report,
we surveyed necroinflammatory and cystic changes of the peribiliary glands
in 1,000 consecutive autopsy livers because these two changes coexisted
frequently in the same liver. The necroinflammatory change was found in
228 livers (22.8%) and the cystic change in 202 livers (20.2%), and 103
cases showed both changes in the same liver. The necroinflammatory change
was frequently found in intrahepatic cholangitis and extrahepatic biliary
obstruction with bacterial infection, suggesting that biliary bacterial
inflammation extends into these peribilary glands. This change was also
frequent in systemic infection or septicemia without biliary bacterial
infection, implying that the peribiliary glands were also damaged in such
conditions without direct infection. The cystic change was frequent in
livers with portal hypertension or obstruction, adult polycystic disease
and necroinflammation of the glands, suggesting that the cystic change
of the glands could occur as the result of the disturbance of intrahepatic
circulation or as the result of inflammatory destruction of the glandular
conduits. Some of peribiliary cysts may be of congenital origin. Dysfunction
related to these pathological changes in the glands may diminish seromucous
secretion and cause alterations in hepatic bile composition. The cystic
change of the glands may retard bile flow by compressing bile duct lumina.
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