IDDF2021-ABS-0028 Microbiologic risk factors of recurrent choledocholithiasis post endoscopic sphincterotomy

BackgroundBile microbiome has a profound influence on recurrence in choledocholithiasis patients post endoscopic sphincterotomy (EST), but the key pathogens and their function on the biliary tract remain unclear.MethodsIn this study, the next-generation sequencing techniques were applied to investigate the biliary microbial characteristics of the recurrent patient‘s post EST and analyze the metabolic functions of the key pathogens, in the hope of finding out the risk factors of recurrence post EST.ResultsResults revealed the distinct clustering of biliary microbiota in recurrent choledocholithiasis from those without recurrence, and a higher relative abundance of Fusobacterium and Neisseria with the absence of Lactobacillus were observed in the bile of the recurrent patients. Functional analysis showed the changes of the microbiome might lead to worse metabolism of carbohydrate and amino acids and more biosynthesis of glycan and other secondary metabolites in the biliary tract, indicating microbiologic influence on recurrence of choledocholithiasis. And survival analysis found out the presence of Lactobacillales in bile might be effective in the prediction of recurrence post EST. (IDDF2021-ABS-0028 Figure A, IDDF2021-ABS-0028 Figure B, IDDF2021-ABS-0028 Figure C, IDDF2021-ABS-0028 Figure D, IDDF2021-ABS-0028 Figure E, IDDF2021-ABS-0028 Figure F)ConclusionsThe result of this study may add evidence to the microbiologic etiology of recurrent cholelithiasis and help to develop new prevention methods to avoid recurrence post EST.