Pathomorphological Changes in Structure of Intrahepatic Ducts and Choledoch in Patients With Acute and Chronic Cholangitis

Abstract

Summary. Aim. To determine the morphological state of bile duct wall cells in patients with acute and chronic cholangitis at different times after removal of bile hypertension.
 Materials and methods. During laparotomy surgery, a bile duct wall biopsy was performed in 48 patients with cholangitis, conditionally divided into 4 groups depending on the period of removal of biliary hypertension: up to 5 days, 12-14 days, 28-30 days and 10-12 months. The control group included 12 patients with choledocholithiasis without clinical signs of cholangitis.
 Results and its discussion. Acute cholestasis was recorded in the intrahepatic bile ducts, the expression of which occurred in the first 2 weeks. In the period of 28-30 days, residual effects of acute cholangitis and proliferation of connective tissue both in the walls of the ducts and around them were recorded. In the bile duct wall of patients with cholangitis, the largest changes were recorded within 3-5 days from the beginning of decompression in the form of edematous-desquamative and necrotic phenomena on the part of the epithelium. On the 12-14th day, “attenuation” and demarcation of the inflammatory process were noted, and on the 28-30th day – the development of connective tissue. In patients with long-term (6-12 months) chronic cholangitis, the phenomena of cholestasis, cholangiosclerosis and biliary cirrhosis of the liver were documented, which were not subjected to regression.
 Conclusions. The most pleasant for reconstructive interventions after the elimination of cholangitis and biliary hypertension is a period of 3-6 weeks. With prolonged cholangitis, the phenomena of sclerosis and cirrhosis are not regressed.