Biliary-intestinal anastomosis leads to alterations in intestinal flora and its flora metabolites and increases the risk of long-term postoperative complications: a case-control study

1. The biliary-intestinal anastomosis, which is performed as part of a pancreaticoduodenectomy, induces significant shifts in the intestinal flora. 2. Increased abundance of Escherichia-Shigella may promote long-term complications after biliary-intestinal anastomosis. 3. Biliary-intestinal anastomosis leads to alterations in the metabolites of the patient's intestinal flora. 4. Intestinal flora and their metabolites in patients after biliary-intestinal anastomosis may contribute to the development of long-term complications through nine metabolic pathways.