Study On The Microbial Structure Of Biliary Tract In Patients With Recurrent Common Bile Duct Stone

Objective: To study the structure of biliary microbiome in patients with recurrent common bile duct stones,and to explore its relationship with the recurrence of common bile duct stones.Methods: Prospectively included patients with recurrent common bile duct stones and non-biliary duct stones who underwent endoscopic retrograde cholangiopancreatography(ERCP)treatment in the Second Department of General Surgery of the First Hospital of Lanzhou University from January 2019 to June 2019.The clinical data of the patients were collected,and bile specimens of patients were collected during ERCP.The 16 S rRNA high-throughput sequencing was used to analyze the microbiome structure of the biliary tract.The study compared the clinical features and biliary tract structure of patients with recurrent common bile duct stones with those of non-biliary duct stones.Results: A total of 27 patients with recurrent common bile duct stones and 19 patients with non-biliary duct stones were included.In terms of Alpha diversity,the Shannon index(2.285 vs 5.612,P = 0.001)and Simpson index(0.537 vs 0.929,P = 0.001)of biliary microbial diversity in patients with recurrent common bile duct stones were significantly lower than those in non-biliary duct stones.In terms of Beta diversity,the two groups showed aggregation state respectively,and there were differences in biliary microbial similarity.In terms of biliary microbial distribution,at the phylum level,both groups were mainly Proteobacteria and Firmicutes.Compared with nonbiliary stones,patients with recurrent common bile stones 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;At the genus level,recurrent common bile duct stones group was mainly the Escherichia,and there were a variety of more evenly distributed microbiome in the bile of non-bile duct stones,and the types of biliary bacteria were more complex and diverse,with significant differences between the two groups.Conclusion: The biliary microbial diversity of patients with recurrent common bile duct stones was decreased.The biliary microbiome are mainly facultative anaerobe Proteobacteria,of which the genus Escherichia is the most abundant.Patients with recurrent common bile duct stones have obvious biliary microbial imbalance,which may be related to the repeated formation of common bile duct stones.