“…Because dysfunction of the biliary system and/or liver can cause a stagnant bile environment, bacteria is likely to flow back via the duodenum-bile-duct route and to remain and replicate in the bile. Several recent studies in humans have reported that the presence of a biliary microbiota is associated with biliary diseases such as cholecystitis, cholangiocarcinoma, and cholesterol gallstones [2,6,10,13]. In human major biliary bacterial phyla were Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria in distal cholangiocarcinoma and the onset of common bile duct stones [2,6,10,13].…”