Fig. 2

Microbial analysis of the oral cavity and the biliary tract. Microbial analysis showed identical microbial species in 33% ERCs (A). Identical microbial analysis in cholangitis and non-cholangitis patients (B). Identical microbes found in throat and bile divided into facultative or unusual pathogens and likely pathogenic microbes (C). Patients undergoing ERC with identical microbial analysis in the oral cavity and bile had no higher cholangitis rates (D). Patients with or without cholangitis had no difference in microbes transmitted to the biliary system (E). In a longitudinal analysis most of these microbes were persistently present in the biliary system (F). Whereas patients with cholangitis and antibiotic therapy matching bile microbiology had a shorter hospital stay (G), the same microbial analysis in the throat and bile did not lead to longer hospital stay (H). Multivariate Cox-Regression analysis identified solely suspected choledocholithiasis as an independent risk factor (I). Abbreviations in order of their appearance: ERC – endoscopic retrograde cholangiography, ns – non significant. =—positive match, ≠—negative match, CRP – c-reactive protein, mg/dl – milligrams/deciliter, HR – hazard ratio, CI – confidence interval