Characterization of biliary and duodenal microbiota in patients with primary and recurrent choledocholithiasis.

PURPOSE

To explore the biliary and duodenal microbiota features associated with the formation and recurrence of choledocholithiasis (CDL).

METHODS

We prospectively recruited patients with primary (P-CDL, n = 29) and recurrent CDL (R-CDL, n = 27) for endoscopic retrograde cholangiopancreatography (ERCP). Duodenal mucosa (DM), bile and bile duct stones (BDS) samples were collected in P- and R-CDL patients. DM samples were also collected in 8 healthy controls (HC). The microbiota profile analysis was performed with 16S rRNA gene sequencing.

RESULTS

Short-course antibiotic application before ERCP showed no significant effects in alpha and beta diversities of the biliary and duodenal microbiota in CDL. Alpha diversity showed no difference between DM and bile samples in CDL. The duodenal microbial richness and diversity was lower in both P- and R-CDL than HC. The biliary microbiota composition showed a high similarity between P- and R-CDL. and were higher abundant in DM, bile, and BDS samples of R-CDL than P-CDL, as well as and in bile samples of R-CDL. The enriched duodenal and biliary bacteria in CDL were closely associated with cholecystectomy, inflammation and liver dysfunction. The bile-associated microbiota of R-CDL expressed enhanced capacity of D-glucuronide and D-glucuronate degradation, implicating an elevated level of β-glucuronidase probably produced by enriched and in bile.

CONCLUSIONS

The duodenal microbiota was in an imbalance in CDL. The duodenal microbiota was probably the main source of the biliary microbiota and was closely related to CDL formation and recurrence. , , and might contribute to CDL recurrence.

CLINICAL TRIALS

The study was registered at the Chinese Clinical Trial Registry (, ChiCTR2000033940).

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13755-023-00267-2.