Effect Of Juxtapapillary Duodenal Diverticulum On Biliary Flora And The Formation Of Common Bile Duct Stones

Objective: To analyze the diversity and correlation of biliary and intestinal flora in patients with common bile duct stone.To explore the characteristics of intestinal flora in patients with common bile duct stone.To investigate the effect of juxtapapillary duodenal diverticulum on the biliary flora and the formation of common bile duct stone.Methods:Bile and intestinal fluid were collected from patients with primary common bile duct stone,and then divided into diverticulum group and non-diverticulum group according to the presence or absence of juxtapapillary duodenal diverticulum,DNA of these samples was extracted and a bacterial gene library was constructed,and related bioinformatics analysis was performed after high-throughput sequencing to obtain the bacterial components and community structure of the sample.Result: A total of 3001,613 valid sequences were obtained,with an average of 136436.95±3696.842 sequences,which were classified into 6021 ASV/OTU.Alpha diversity analysis showed that the species richness and diversity in the diverticulum group were lower than those in the non-diverticulum group,and the species richness and diversity of bile were higher than intestinal fluid in the same group.According to the species annotation results,the advantage bacterium group of the bile is Proteobacteria(BG 80.41%,Bg 70.95%),and advantage bacterium group of the intestinal fluid is Firmicutes and Proteobacteria(DG 89.39%,Dg 74.11%).A substantial proportion of Enterobacter was found in bile,Escherichia coli,Klebsiella,Streptococcus and other bacteria closely related to stone formation were found ?-glucuronidase producing species were increased in bile,and more complex in the diverticulum group.Due to the influence of the juxtapapillary duodenal diverticulum,the intestinal flora will be changed and then the biliary flora will also change.Conclusion:The presence of juxtapapillary duodenal diverticulum can affect the biliary flora,leading to an increase in bacteria associated with the formation of stones,thereby affecting the formation of common bile duct stones and making them easier to form.