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Biliary Tract Diseases

Digestive System and Liver · NLM MeSH · updated 2026-11-04 · version 1

Citations verified against PubMedNot yet clinician-reviewed9 referencesApproximately 3 min read

Diseases in any part of the biliary tract including the bile ducts and the gallbladder.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 3 complete abstracts (609 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

Diseases in any part of the biliary tract including the bile ducts and the gallbladder.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Biliary Tract Disease; Disease, Biliary Tract; Diseases, Biliary Tract; Tract Disease, Biliary; Tract Diseases, Biliary.

Where it fits in the MeSH classification

Broader topics
Digestive System Diseases
Narrower topics
Bile Duct Diseases; Bile Reflux; Biliary Tract Neoplasms; Cholelithiasis; Gallbladder Diseases; Postcholecystectomy Syndrome
See also
Cholangiography

Related concepts

  • Biliary Tract
  • Bile Ducts
  • Gallbladder

Research landscape

PubMed indexes 153,585 records tagged with the MeSH heading “Biliary Tract Diseases” (counts retrieved 2026-11-04). 22,931 of them (14.9%) were published from 2020 onward, and the busiest period so far is through 1999 with 75,211 records.

Reviews account for 17,937 records (11.7%) and meta-analyses for 1,481. Randomized controlled trials number 2,261 (1.5%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 75,211 records; 2000-2009: 24,486 records; 2010-2019: 30,957 records; 2020 onward: 22,931 records75,211through 199924,4862000-200930,9572010-201922,9312020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 199975,211
2000-200924,486
2010-201930,957
2020 onward22,931
Share of records by publication typeReviews: 11.7 percent; Meta-analyses: 1.0 percent; Randomized controlled trials: 1.5 percentReviews11.7% (17,937)Meta-analyses1.0% (1,481)Randomized controlled trials1.5% (2,261)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 153,585 PubMed records
TypeRecordsShare
Reviews17,93711.7%
Meta-analyses1,4811.0%
Randomized controlled trials2,2611.5%

Method: PubMed query "Biliary Tract Diseases"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.

Reading the evidence in digestive system and liver

Gut and liver research ranges from laboratory studies of the microbiome to large trials of drugs and surgery. Symptoms such as pain, reflux or bowel change are reported by patients and overlap between conditions, and diet and microbiome studies are mostly observational. Check whether the study measured symptoms, tissue findings or long-term outcomes, how the diagnosis was made and how long people were followed. Nothing here replaces advice from a qualified clinician.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Microbiota in cholestatic diseases: crosstalk among bile composition, the biliary microbiome, and host immunity
Yang Y, Ren L, Zhang Y, Wang X, Shang J, Zhang L
2026Review article
Design not recorded in structured metadata
2cc by
PMID 42558207 · DOI · PMC13437312
Case Report: Successful conversion of gallbladder cancer with intrahepatic metastases using camrelizumab combined with gemcitabine and cisplatin
Wang D, Li Y, Shi G, Wang W, Ma T, Mi C, et al.
2026Research article
Design not recorded in structured metadata
2cc by
PMID 42238589 · DOI · PMC13227397
Gut microbiota-derived imidazole propionate promotes primary sclerosing cholangitis via p38 signalling
Molinaro A, Braadland PR, Carpino G, Carreras A, Nikolaidis M, Hanzely P, et al.
2026Research article
Design not recorded in structured metadata
1cc by
PMID 42698000 · DOI · PMC13597309

Microbiota in cholestatic diseases: crosstalk among bile composition, the biliary microbiome, and host immunity [1]

Review article Yang Y, Ren L, Zhang Y, Wang X, Shang J, Zhang L · · 2026 · cited 2 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Cholestatic liver diseases are a heterogeneous group of hepatobiliary disorders caused by impaired bile formation, secretion, or excretion, leading to hepatocyte injury, biliary inflammation, fibrosis, and eventually cirrhosis.
Closing excerpt
Despite challenges including sampling difficulty, interindividual variability, and limitations of current models, future technologies such as single-cell sequencing, spatial transcriptomics, and multi-omics integration may enable precision diagnosis and targeted therapy.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (233 words)

Cholestatic liver diseases are a heterogeneous group of hepatobiliary disorders caused by impaired bile formation, secretion, or excretion, leading to hepatocyte injury, biliary inflammation, fibrosis, and eventually cirrhosis. Traditional studies have largely focused on isolated mechanisms, including bile acid toxicity, immune dysregulation, and genetic susceptibility. However, recent advances in metagenomics, metabolomics, and immunology have highlighted the critical role of the gut and biliary microbiota in disease pathogenesis. This review proposes the core concept of a "tripartite interplay among bile composition, biliary microbiome, and host immunity," integrating the dynamic crosstalk among these three axes in cholestatic liver diseases. Bile composition shapes microbial communities and modulates immune responses through receptors such as FXR and TGR5. In turn, the biliary microbiome regulates bile acid metabolism and immune activity through microbial metabolites. Meanwhile, the host immune system senses microbial signals via pattern-recognition receptors, triggering inflammatory pathways and influencing microbial colonization and metabolism. These reciprocal interactions form complex feedback loops that drive disease progression from early inflammation to chronic fibrosis and cirrhosis. Based on this framework, emerging diagnostic approaches combine microbial signatures, bile acid profiles, and immune markers into multidimensional biomarker systems. Therapeutically, integrated strategies targeting the microbiome, bile acid metabolism, and immune pathways may offer synergistic benefits. Despite challenges including sampling difficulty, interindividual variability, and limitations of current models, future technologies such as single-cell sequencing, spatial transcriptomics, and multi-omics integration may enable precision diagnosis and targeted therapy.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42558207 · DOI · PMC13437312

Case Report: Successful conversion of gallbladder cancer with intrahepatic metastases using camrelizumab combined with gemcitabine and cisplatin [2]

Research article Wang D, Li Y, Shi G, Wang W, Ma T, Mi C, et al. · · 2026 · cited 2 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundGallbladder cancer is an extremely aggressive malignant tumor of the digestive system.
Closing excerpt
However, its definitive efficacy and the specific role of camrelizumab still require validation through large-scale clinical trials.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (217 words)

BackgroundGallbladder cancer is an extremely aggressive malignant tumor of the digestive system. It presents with no obvious symptoms in its early stages, meaning most patients are already in advanced stages at diagnosis. The response to neoadjuvant therapy for gallbladder cancer is poor, and the majority of patients with advanced gallbladder cancer cannot achieve tumor downstaging through drug treatment to become eligible for surgery. This case focuses on discussing the selection of immunotherapy drugs and the determination of their treatment cycles.Case summaryThis case report describes a patient with gallbladder cancer and intrahepatic metastases. Following contrast-enhanced computed tomography (CECT) evaluation, R0 resection of the lesions was deemed unfeasible. The patient underwent conversion therapy with camrelizumab combined with gemcitabine and cisplatin. The patient responded well to this regimen, with rapid tumor shrinkage after three cycles of treatment. Grade IV neutropenia developed during therapy but resolved without serious consequences following prompt intervention. After reassessment, the patient underwent open cholecystectomy combined with segmental resection of the liver segments IVb/V, lymph node dissection, and high hepaticojejunal anastomosis. Postoperative recovery was favorable, with PFS reaching 18 months.ConclusionThe regimen of camrelizumab combined with gemcitabine and cisplatin demonstrated potential conversion therapy value in this patient with advanced gallbladder cancer. However, its definitive efficacy and the specific role of camrelizumab still require validation through large-scale clinical trials.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42238589 · DOI · PMC13227397

Gut microbiota-derived imidazole propionate promotes primary sclerosing cholangitis via p38 signalling [3]

Research article Molinaro A, Braadland PR, Carpino G, Carreras A, Nikolaidis M, Hanzely P, et al. · · 2026 · cited 1 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the bile ducts that can lead to biliary cancer and end-stage liver disease.
Closing excerpt
Therefore, targeting ImP production or signalling may represent therapeutic avenues in PSC.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (159 words)

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the bile ducts that can lead to biliary cancer and end-stage liver disease. PSC is associated with inflammatory bowel disease and an altered gut microbiota. However, the molecular mechanisms underlying gut-liver interactions in PSC remain poorly characterized. Here we show that the gut microbiota-derived metabolite imidazole propionate (ImP) is a disease driver in PSC. Individuals with PSC have higher circulating ImP levels than individuals with related conditions, and high ImP levels predict reduced survival in PSC. Cholangiocytes exposed to ImP show activated mammalian target of rapamycin complex 1 (mTORC1) signalling and secrete pro-inflammatory and pro-fibrogenic factors. Chronic administration of ImP to mice induces liver inflammation and fibrosis through a p38-dependent mechanism, upstream of mTORC1. We propose that chronic exposure to ImP induces cholangiocyte injury, which alone or in concert with other factors causes clinical worsening of PSC. Therefore, targeting ImP production or signalling may represent therapeutic avenues in PSC.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42698000 · DOI · PMC13597309

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials [4]
    He L, Wang J, Ping F, Yang N, Huang J, Li Y, et al. · JAMA Intern Med · 2022 · cited 260 times (Europe PMC)
  • Research article Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis [5]
    Wang X, Yu W, Jiang G, Li H, Li S, Xie L, et al. · Clin Gastroenterol Hepatol · 2024 · cited 172 times (Europe PMC)
  • Research article Safety issues of tirzepatide (pancreatitis and gallbladder or biliary disease) in type 2 diabetes and obesity: a systematic review and meta-analysis [6]
    Zeng Q, Xu J, Mu X, Shi Y, Fan H, Li S · Front Endocrinol (Lausanne) · 2023 · cited 56 times (Europe PMC)
  • Research article Adverse events with EUS-guided biliary drainage: a systematic review and meta-analysis [7]
    Giri S, Mohan BP, Jearth V, Kale A, Angadi S, Afzalpurkar S, et al. · Gastrointest Endosc · 2023 · cited 50 times (Europe PMC)
  • Research article Age at surgery and native liver survival in biliary atresia: a systematic review and meta-analysis [8]
    Hoshino E, Muto Y, Sakai K, Shimohata N, Urayama KY, Suzuki M · Eur J Pediatr · 2023 · cited 43 times (Europe PMC)
  • Research article GWAS meta-analysis of intrahepatic cholestasis of pregnancy implicates multiple hepatic genes and regulatory elements [9]
    Dixon PH, Levine AP, Cebola I, Chan MMY, Amin AS, Aich A, et al. · Nat Commun · 2022 · cited 43 times (Europe PMC)

References

  1. Yang Y, Ren L, Zhang Y, Wang X, Shang J, Zhang L. Microbiota in cholestatic diseases: crosstalk among bile composition, the biliary microbiome, and host immunity. . 2026. PMID 42558207 · DOI · PMC13437312
  2. Wang D, Li Y, Shi G, Wang W, Ma T, Mi C, et al.. Case Report: Successful conversion of gallbladder cancer with intrahepatic metastases using camrelizumab combined with gemcitabine and cisplatin. . 2026. PMID 42238589 · DOI · PMC13227397
  3. Molinaro A, Braadland PR, Carpino G, Carreras A, Nikolaidis M, Hanzely P, et al.. Gut microbiota-derived imidazole propionate promotes primary sclerosing cholangitis via p38 signalling. . 2026. PMID 42698000 · DOI · PMC13597309
  4. He L, Wang J, Ping F, Yang N, Huang J, Li Y, et al.. Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med. 2022. PMID 35344001 · DOI · PMC8961394
  5. Wang X, Yu W, Jiang G, Li H, Li S, Xie L, et al.. Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol. 2024. PMID 38382725 · DOI
  6. Zeng Q, Xu J, Mu X, Shi Y, Fan H, Li S. Safety issues of tirzepatide (pancreatitis and gallbladder or biliary disease) in type 2 diabetes and obesity: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023. PMID 37908750 · DOI · PMC10613702
  7. Giri S, Mohan BP, Jearth V, Kale A, Angadi S, Afzalpurkar S, et al.. Adverse events with EUS-guided biliary drainage: a systematic review and meta-analysis. Gastrointest Endosc. 2023. PMID 37392952 · DOI
  8. Hoshino E, Muto Y, Sakai K, Shimohata N, Urayama KY, Suzuki M. Age at surgery and native liver survival in biliary atresia: a systematic review and meta-analysis. Eur J Pediatr. 2023. PMID 36997770 · DOI
  9. Dixon PH, Levine AP, Cebola I, Chan MMY, Amin AS, Aich A, et al.. GWAS meta-analysis of intrahepatic cholestasis of pregnancy implicates multiple hepatic genes and regulatory elements. Nat Commun. 2022. PMID 35977952 · DOI · PMC9385867

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-11-04.

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EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.

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Related research topics

  • Bile DuctsAnatomy and Physiology
  • Gallbladder DiseasesDigestive System and Liver
  • GallstonesDigestive System and Liver
  • CholecystitisDigestive System and Liver
  • Cystic DuctAnatomy and Physiology
  • CholangiographyDiagnostics and Medical Technology

All 66 articles in Digestive System and Liver →

At a glance

153,585
PubMed records on this heading
15%
published since 2020
17,937
review articles
2,261
randomized trials
9
verified references below

Counts come from PubMed on 2026-11-04; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Bile DuctsAnatomy and Physiology
  • Gallbladder DiseasesDigestive System and Liver
  • GallstonesDigestive System and Liver
  • CholecystitisDigestive System and Liver
  • Cystic DuctAnatomy and Physiology

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