Abstract
Objective Common bile duct stone (CBDS) recurrence is associated with bile microbial structure. This study explored the structure of bile microbiome in patients with recurrent CBDS, and its relationship with the recurrence of CBDS. Methods Patients with recurrent CBDS (recurrence group) and controls without CBDS (control group) requiring endoscopic retrograde cholangiopancreatography (ERCP) were prospectively included. The control group was noncholelithiasis patients, mainly including benign and malignant biliary stenosis. Bile samples were collected, and bile microbiome structure was analyzed by the 16S rRNA encoding gene (V3–V4). Results A total of 27 patients in the recurrence group and 19 patients in the control group were included. The diversity of bile microbiome in the recurrence group was significantly lower than that in the control group (Shannon index: 2.285 vs. 5.612, P = 0.001). In terms of bile microbial distribution, patients with recurrent CBDS had significantly higher Proteobacteria (86.72% vs. 64.92%, P = 0.037), while Bacteroidetes (3.16% vs. 8.53%, P = 0.001) and Actinobacteria (0.29% vs. 6.74%, P = 0.001) are significantly lower compared with the control group at the phylum level. At the genus level, the recurrence group was mainly the Escherichia, and there was a variety of more evenly distributed microbiome in the control group, with significant differences between the two groups. Conclusion The diversity of bile microbiome in patients with recurrent CBDS is lower. Patients with recurrent CBDS may have bile microbial imbalance, which may be related to the repeated formation of CBDS.
Highlights
Common bile duct stone (CBDS) is a common and frequently occurring disease of the digestive system
The recurrence group was all patients with recurrent CBDS, accompanied by at least one stone removal history six months ago
Compared with the control group, patients in the recurrence group were more likely to have a history of endoscopic retrograde cholangiopancreatography (ERCP), cholecystectomy, or bile duct surgery, which may be caused by our inclusion criteria
Summary
Common bile duct stone (CBDS) is a common and frequently occurring disease of the digestive system. There has been relatively little research on biliary tract microbiology. Some researchers have used 16S rRNA gene-based sequencing to analyze the bile microbiome in patients with gallstones. Both patients with gallstones and nonpathological bile have their own microbiome, and the relative abundance of the two groups in different taxa is significantly different [8]. Studies have shown that all bile microbiome can be detected in the upper digestive tract in CBDS patients, and the bile microbiome was more similar to those of the duodenal fluid samples than to those of the gastric fluid or saliva samples [9]. It can be inferred that there are many changes in the bile microbiome in patients with gallstones. The characteristics of the bile microbiome in patients with recurrent CBDS have not been studied so far
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