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Therefore, the V1\u2013V2 region of the 16S rRNA gene was sequenced in 175 bile samples. Samples from patients with anastomotic strictures (AS) served as controls. Multivariate analysis and in silico metagenomics were applied cross\u2010sectionally and longitudinally. The microbial community differed significantly between ITBL and AS in terms of alpha and beta diversity. Both, antibiotic treatment and stenting were associated independently with differences in the microbial community structure. In contrast to AS, in ITBL stenting was associated with pronounced differences in the biliary microbiome, whereas no differences associated with antibiotic treatment could be observed in ITBL contrasting the pronounced differences found in AS. Bacterial pathways involved in the production of antibacterial metabolites were increased in ITBL with antibiotic treatment. After liver transplantation, the biliary tract harbours a complex microbial community with significant differences between ITBL and AS. Fundamental changes in the microbial community in ITBL can be achieved with biliary stenting. However, the effect of antibiotic treatment in ITBL was minimal. Therefore, antibiotics should be administered wisely in order to reduce emerging resistance of the biliary microbiome towards external antibiotics.<\/jats:p>","DOI":"10.1111\/liv.15194","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T08:13:32Z","timestamp":1644740012000},"page":"1070-1083","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The biliary microbiome in ischaemic\u2010type biliary lesions can be shaped by stenting but is resilient to antibiotic treatment"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1824-0200","authenticated-orcid":false,"given":"Friederike","family":"Klein","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Hepatology and Endocrinology, Hannover Medical School  Hannover Germany"},{"name":"German Center for Infection Research (DZIF)  Hannover\/Braunschweig Germany"},{"name":"Microbial 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