Mucin-associated T antigens in benign and malignant epithelium of the gall bladder,extrahepatic bile ducts and ampulla of Vater

The mucin-associated antigens Tn, sialosyl-Tn (STn), T and sialosyl-T (STAg) antigens accumulate through aberrant and incomplete glycosylation in malignant epithelial cells. Their diagnostic and prognostic significance in tumours of the colon and cervix has been described, and a possible role for Tn antigen in cell-to-cell adhesion has been suggested. These antigens have been demonstrated through peanut agglutinin (PNA) lectin binding and more recently using specific monoclonal antisera. Differences between the two methods have been described, which may be due to fixation schedules and/or specificity. We have investigated the effect of fixation on the binding of biotinylated PNA lectin and compared its reactivity with the immunoreactivity of monoclonal antisera to Tn, STn, T and STAg antigens in benign and malignant epithelium of the gall bladder, extrahepatic bile ducts and ampulla of Vater. We found that short-term fixation in formol sublimate resulted in poor PNA binding. All other tested fixation schedules showed strong perinuclear binding, similar to that found on cryostat sections. When compared with monoclonal antisera, PNA binding demonstrated the lowest specificity in benign epithelium. In both benign and malignant epithelium, the two methods cannot substitute for each other. STn and STAg antigens were found to be oncodevelopmental throughout the extrahepatic biliary tract. When used in a panel, they are useful as diagnostic markers of malignancy in gall bladder epithelium.     

Occurrence of anastomoses of the intrahepatic bile ducts

Eighty-four human livers were investigated with regard to the existence of vascular communications within their biliary tracts. Even with the help of a most subtle technique we could not detect any junctions between the bile ducts, so that there is no evidence of primary anastomoses between the main lobes, between the segments, or inside the segments. In case of chronic biliary obstruction only the major ducts, e.g., up to the fourth generation, are amplified. There is an inflammatory reaction around the smaller vessels, followed by fibrosis and shrinking of the connective tissue. That is why the formation of secondary anastomoses cannot happen under pathological conditions.     

Advances in the generation of bioengineered bile ducts

The generation of bioengineered biliary tissue could contribute to the management of some of the most impactful cholangiopathies associated with liver transplantation, such as biliary atresia or ischemic cholangiopathy. Recent advances in tissue engineering and in vitro cholangiocyte culture have made the achievement of this goal possible. Here we provide an overview of these developments and review the progress towards the generation and transplantation of bioengineered bile ducts. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni and Peter Jansen.     

Ultrasonography of the bile ducts after cholecystectomy]

The paper is concerned with the results of multiprojectional ultrasound investigation of the biliferous system in 68 patients at varying time after cholecystectomy. In most cases (77.9%) signs of dilated biliary ducts were undetectable. Dilatation of the hepaticodoch was most frequently determined by choledolithiasis, stricture or stenosing papillitis, rarely--by pancreatic head cancer. Investigation of the biliary ducts in patients after cholecystectomy should be started with ultrasound tomography; endoscopic retrograde cholangiopancreatography or i.v. cholangiography and dynamic cholescintigraphy were indicated after the detection of the signs of dilated ducts (the anteroposterior diameter of the common hepatic duct was over 6 mm).     

The functions of bile ducts in sheep

Pressure changes in the gallbladder and the bile flow and pressure changes in the common bile duct were determined in sheep. The experiments were conducted on animals with external junction of choleslochus and cholecystostomy performed previously. The experiments demonstrated pressure in the sheep of the functional sphincter of Mirizzi at the boundary between the intrahepatic and extrahepatic bile ducts. A correlation was demonstrated also between the function of this sphincter and that of Oddi's sphincter. The conditions for bile filling of the extrahepatic bile ducts and gallbladder were determined. The process of bile excretion into the duodenum and the role of bile duct sphincters in this process are discussed. Attention is called to the relationship between the pressure in the gallbladder and the tonus of bile duct sphinters.