EVALUATION OF THE DISTRIBUTION OF INTERSTITIAL CELLS OF CAJAL IN THE HUMAN EXTRAHEPATIC BILE DUCTS

43. Ulusal Çocuk Cerrahisi kongresi ve Mısır Çocuk Cerrahisi ortak kongresi, İstanbul, Türkiye, 21 - 24 Ekim 2026, ss.103-104, (Özet Bildiri)

Introduction: Interstitial cells of Cajal (ICCs), known as the pacemaker cells of the gastrointestinal tract, are believed

to regulate biliary motility. Although ICCs have been identified in the human gallbladder and several segments of the

extrahepatic biliary tract, their distribution throughout the entire extrahepatic biliary system has not been systematically

investigated. Furthermore, their role in biliary tract diseases remains unclear.

Materials and Methods: This study evaluated the presence, distribution, and density of ICCs throughout the human

extrahepatic biliary system and investigated changes in ICC distribution in biliary tract pathologies. Tissue specimens

were obtained from patients who underwent pancreaticoduodenectomy (Whipple procedure), healthy extrahepatic

bile ducts collected during forensic autopsies, and paraffin-embedded tissues from patients with biliary atresia who

underwent the Kasai procedure. Specimens were anatomically classified and examined according to their histological

layers. Clinical and laboratory data were also analyzed.

Results: ICCs were identified throughout the extrahepatic biliary system. The highest density was observed in the

muscular layer and around the peribiliary glands. Anatomically, ICC density was greatest in the pancreatic portion

of the common bile duct and lowest in the common hepatic duct. Sections containing the sphincter of Oddi showed

a marked increase in ICC density. In biliary atresia, ICC density increased in areas of prominent inflammation and

epithelial proliferation. Tissues with a high tumor burden demonstrated increased ICC density in all anatomical layers.

Higher ICC density in the pancreatic common bile duct was associated with elevated liver function tests and poorer

survival.

Conclusions: ICCs are widely distributed throughout the human extrahepatic biliary system, particularly within the

muscular layer and around the peribiliary glands, supporting their role in biliary motility and secretion. Increased ICC

density in the sphincter of Oddi, biliary atresia, and tumor tissues suggests a potential role in pathological remodeling