Helicobacter Pylori Infection in Patients with Chronic Calcular Cholecystitis a Cross- Sectional Study

Abstract

Aims: Helicobacter pylori was found in the bile and gallbladder, so we are aiming to examine the relationship between H. pylori-like bacteria and chronic calcular cholecystitis. METHODS: This cross-sectional study was conducted at our hospitals from May 2011 to January 2012. One hundred and forty patients with chronic calcular cholecystitis were enrolled in this study. Gastroscopy with gastric or duodenal H.pylori urease test and detection of H. pylori in serum were done before the surgical procedure for all patients. After cholecystectomy, the gallbladder tissue was investigated for H. pylori by rapid urease test and Geimsa stain. RESULTS: Of all 140 patients 62.1 % were females, mean age of our patients was 39.04 ± 7.3 years. H. pylori IgG antibody titre was positive in 32 patients with biliary duodenitis, in 43 patients with biliary gastritis, and in 18 patients with duodenal ulcer. The gastric rapid urease test was positive in 40.7 %. The gallbladder rapid urease test was positive in 25 %. In 24 patients both gastric and gallbladder mucosa tested positive for rapid urease test. In 28 patients, the gastric urease test was positive while the gallbladder mucosa tested negative. In 13 patients, the gallbladder mucosa tested positive while the gastric mucosa was negative. There was a significant correlation between the rapid urease test in the gallbladder and in the gastric or duodenal mucosa (P = 0.002). Modified Geimsa staining of gallbladder specimens revealed that H. pylori-like bacteria were detected in 63.6 %. There was a significant correlation between histopathological examination of gallbladder mucosa stained with Geimsa stain and the gallbladder rapid urease test (P < 0.001), but not correlated with the gastric urease test (P = 0.210). CONCLUSION: Our study demonstrates that H. pylori is present in the gallbladder mucosa in patients with chronic calcular cholecystitis and might be an etiological cause of chronic inflammation`.