An observational study to assess the Helicobacter pylori infection rates in patients with cholelithiasis

Authors

  • Jeevan Kankaria Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
  • Santosh Madagond Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
  • Akshita Bhat Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20231731

Keywords:

Cholelithiasis, Helicobacter pylori, Laparoscopic cholecystectomy, Upper GI endoscopy, Warthin starry silver stain

Abstract

 Background: Cholelithiasis and chronic cholecystitis cholelithiasis is fairly common all around the world. Since chronic inflammation causes repeated trauma to the gallbladder mucosa and DNA damage led by high or abnormal bile acid exposure, gallstones are closely related to the development of hepatobiliary cancers. After cholecystectomy, some patients experience ongoing upper abdomen pain, which is distressing for the surgeons and raises the possibility of a concomitant upper gastrointestinal issue, which in most cases turned out to be peptic ulcer disease. Numerous studies have found various Helicobacter species in the gallbladder tissue, gallstones, and bile taken from the gallbladder. We conducted this study to assess the relationship between cholelithiasis and H. pylori infection in the stomach. Ascending infection of H. pylori from the stomach and duodenum to biliary tree may have function in development of gall stone production and hepatobiliary carcinomas.

Methods: Hospital based cross sectional observational study on patients admitted in surgical wards of SMS Hospital Jaipur for laparoscopic cholecystectomy. All patients underwent UGI and gastric antral biopsy followed by laparoscopic cholecystectomy, gastric mucosa and GB mucosa were subjected to Warthin starry silver stain for detection of H. pylori.

Results: Out of 116 patients who underwent upper GI endoscopy followed by laparoscopic cholecystectomy, 29 (25%) patients were positive for H. pylori infection.

Conclusions: This study shows significant positive co-relation between H. pylori infection in stomach, gall bladder to chronic cholecystitis and cholelithiasis, which signifies gastric colonisation of H. pylori has it’s role in biliary pathologies through ascending infection, the effectiveness of H. pylori eradication therapy in preventing these pathologies need to be studied further.

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References

Marshall B, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. The Lancet. 1984;323(8390):1311-5.

Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. New Eng J Med. 2001;345(11):784-9.

GD PJ, Vandersteen DP, Chang Y, Vogelman JH, Orentreich N, Sibley RK. Helicobacter pylori infection and the risk of gastric carcinoma. New Eng J Med. 1991;325(16):1127-31.

Eidt S, Stolte M, Fischer R. Helicobacter pylori gastritis and primary gastric non-Hodgkin’s lymphomas. J Clin Pathol. 1994;47(5):436-9.

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut and Liver. 2012;6(2):172-87.

Ryu S, Chang Y, Yun KE, Jung HS, Shin JH, Shin H. Gallstones and the risk of gallbladder cancer mortality: a cohort study. Am J Gastroenterol. 2016;111(10):1476-87.

Kawaguchi M, Saito T, Ohno H, Midorikawa S, Sanji T, Handa Y, et al. Bacteria closely resembling Helicobacter pylori detected immunohistologically and genetically in resected gallbladder mucosa. J Gastroenterol. 1996;31:294-8.

Apostolov E, Al-Soud WA, Nilsson I, Kornilovska I, Usenko V, Lyzogubov V, Gaydar Y, Wadström T, Ljungh Å. Helicobacter pylori and other Helicobacter species in gallbladder and liver of patients with chronic cholecystitis detected by immunological and molecular methods. Scand J Gastroenterol. 2005;40(1):96-102.

Al-Soud DF, Hu L, Yi PH. Pyloriexist in the gallbladder mucosa of patients with chronic cholecystitis. World J Gastroenterol. 2007;13(10):1608-11.

Maurer KJ, Carey MC, Fox JG. Roles of infection, inflammation, and the immune system in cholesterol gallstone formation. Gastroent. 2009;136(2):425-40.

Wang Y, Qi M, Qin C, Hong J. Role of the biliary microbiome in gallstone disease. Expert Revi Gastroenterol Hepatol. 2018;12(12):1193–1205.

Qi IN, Romanova TI. Gallstone disease and microbiome. Microorgan. 2020;8(6).

Kankaria J, Yadav AK. Ten-point strategy for safe laparoscopic cholecystectomy: a prospective study. World J Lap Surg. 2020;13(2):55-60.

Pandey M. Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases. World J Surg Onc. 2007;5(94).

AL-Hasnawi SM. Prevalence of Helicobacter pylori among patients with cholelithiasis. Internat J. 2019;2(5):93.

Takahashi T, Yujiri T, Shinohara K, Inoue Y, Sato Y, Fujii Y, et al. Molecular mimicry by Helicobacter pylori CagA protein may be involved in the pathogenesis of H. pylori-associated chronic idiopathic thrombocytopenic purpura. Br J Haematol. 2004;124(1):91-6.

Zhou D, Guan WB, Wang JD, Zhang Y, Gong W, Quan ZW. A comparative study of clinicopathological features between chronic cholecystitis patients with and without Helicobacter pylori infection in gallbladder mucosa. PLoS One. 2013;8(7):e70265.

Issa AH, Muthena MM, Al-Badran A. Detection of salmonella typhi and helicobacter genus in gallstone patients. W J Pharma Res. 2014;3(10):271-86.

Ghazal A, El Sabbagh N, El Riwini M. Presence of Helicobacter spp. DNA in the gallbladder of Egyptian patients with gallstone diseases. EMHJ. 2011;17(12):925-9.

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Published

2023-05-30

How to Cite

Kankaria, J., Madagond, S., & Bhat, A. (2023). An observational study to assess the Helicobacter pylori infection rates in patients with cholelithiasis . International Surgery Journal, 10(6), 1037–1043. https://doi.org/10.18203/2349-2902.isj20231731

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Original Research Articles