{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:07:43Z","timestamp":1790518063744,"version":"4.1.0"},"reference-count":146,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Recent evidence regarding microbiota is modifying the cornerstones on pathogenesis and the approaches to several gastrointestinal diseases, including biliary diseases. The burden of biliary diseases, indeed, is progressively increasing, considering that gallstone disease affects up to 20% of the European population. At the same time, neoplasms of the biliary system have an increasing incidence and poor prognosis. Framing the specific state of biliary eubiosis or dysbiosis is made difficult by the use of heterogeneous techniques and the sometimes unwarranted invasive sampling in healthy subjects. The influence of the microbial balance on the health status of the biliary tract could also account for some of the complications surrounding the post-liver-transplant phase. The aim of this extensive narrative review is to summarize the current evidence on this topic, to highlight gaps in the available evidence in order to guide further clinical research in these settings, and, eventually, to provide new tools to treat biliary lithiasis, biliopancreatic cancers, and even cholestatic disease.<\/jats:p>","DOI":"10.3390\/microorganisms10020312","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T05:26:17Z","timestamp":1643433977000},"page":"312","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Biliary Diseases from the Microbiome Perspective: How Microorganisms Could Change the Approach to Benign and Malignant Diseases"],"prefix":"10.3390","volume":"10","author":[{"given":"Cecilia","family":"Binda","sequence":"first","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Gibiino","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8791-7764","authenticated-orcid":false,"given":"Chiara","family":"Coluccio","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Sbrancia","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2905-1146","authenticated-orcid":false,"given":"Elton","family":"Dajti","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, Ausl Romagna, 47121 Forl\u00ec, Italy"},{"name":"Department of Medical and Surgical Sciences\u2013DIMEC, Alma Mater Studiorum\u2013University of Bologna, 90015 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Fondazione Istituto San Raffaele-G. Giglio, 90015 Cefal\u00f9, Italy"},{"name":"Euro-Mediterranean Institute of Science and Technology (IEMEST), 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-8753","authenticated-orcid":false,"given":"Gabriele","family":"Capurso","sequence":"additional","affiliation":[{"name":"Division of Pancreato-Biliary Endoscopy and EUS, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, 20132 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5012-7355","authenticated-orcid":false,"given":"Vittorio","family":"Sambri","sequence":"additional","affiliation":[{"name":"Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy"},{"name":"Unit of Microbiology, Department of Pathological Anatomy, Trasfusion Medicine and Laboratory Medicine, University of Bologna, 40125 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5269-1964","authenticated-orcid":false,"given":"Alessandro","family":"Cucchetti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences\u2013DIMEC, Alma Mater Studiorum\u2013University of Bologna, 90015 Bologna, Italy"},{"name":"Department of General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Ercolani","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences\u2013DIMEC, Alma Mater Studiorum\u2013University of Bologna, 90015 Bologna, Italy"},{"name":"Department of General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, Ausl Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.12998\/wjcc.v8.i6.1013","article-title":"Microbiota-gut-brain axis and its affect in-flammatory bowel disease: Pathophysiological concepts and insights for clinicians","volume":"8","author":"Sinagra","year":"2020","journal-title":"World J. 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