Association of Clinicopathological features of cholecystitis with H.pylori infection in Gall bladders

Abstract

Background: Since H pylori has been mostly associated with gastritis its presence in other parts of gastrointestinal system has not been studied much. Few previous studies have identified “H pylori” in gallbladder and found its association in causing cholecystitis and gallstones but only a few studies have been performed in Pakistan that have shown a significant association. Therefore, in this study we looked for the presence of this microorganism in cholecystitis patients and its association with the morphological changes seen in gall bladders.
 Material and method: All patients with acute and chronic cholecystitis admitted in ANTH between the ages of 18 and 75 years from January 2017 till March 2019, who underwent cholecystectomy, were included in the study. Gall bladder specimens after surgery were sent to Pathology department ANTH and specimens were analyzed for the presence of H pylori bacteria using H&E and Giemsa staining. Signs of inflammation, any hyperplasia, metaplasia, mucosal atrophy or erosion, lymphoid infiltration, fibrosis, cholesterolosis or any other morphological changes were also noted. Association of H.pylori with cholecystitis and other morphological changes were checked by Chi Square analysis. P. value less than 0.05 was considered statistically significant
 Results: Chronic cholecystitis was present in 91% cases and acute cholecystitis in 9%. Other histological findings were Hyperplasia (10%), Metaplasia (15%), Fibrosis (79%), Cholesterolosis (19%) and ulcerations (36%). H pylori was found in 17% of gall bladders and all the cases were of chronic cholecystitis. Among these, there were 11.7% Males and 88% Females. Gallstones were present in 76.4% cases and age group involvement was seen more among 41-60 years (64.7%). Other histological findings seen in hpylori positive cases were; Hyperplasia in 11.7% cases, Metaplasia in 17.6%, Fibrosis in 94.1%, cholesterolosis in 23.5% and ulcerations in 17.6% cases. Association of H-Pylori with gender, cholecystitis, gall stones, histological features and age distribution was non-significant.
 Conclusion: Although H pylori infection has been found in cases of chronic cholecystitis and gall stone formation, its association with cholecystitis and other morphological changes could not be proved. Hence, it is uncertain whether H pylori eradication in patients with gastritis can prevent cholecystitis or gall stones formation