Relation of Gallbladder Function and <i>Helicobacter pylori</i> Infection to Gastric Mucosa Inflammation in Patients with Symptomatic Cholecystolithiasis

Abstract

Background: Inflammatory alterations of the gastric mucosa are commonly caused by Helicobacter pylori (Hp) infection in patients with symptomatic gallstone disease. However, the additional pathogenetic role of an impaired gallbladder function leading to an increased alkaline duodenogastric reflux is controversially discussed. Aim: To investigate the relation of gallbladder function and Hp infection to gastric mucosa inflammation in patients with symptomatic gallstones prior to cholecystectomy. Patients: Seventy-three patients with symptomatic gallstones were studied by endoscopy and Hp testing. Methods: Gastritis classification was performed according to the updated Sydney System and gallbladder function was determined by total lipid concentration of gallbladder bile collected during mainly laparoscopic cholecystectomy. Results: Fifteen patients revealed no, 39 patients mild, and 19 moderate to marked gastritis. No significant differences for bile salts, phospholipids, cholesterol, or total lipids in gallbladder bile were found between these three groups of patients. However, while only 1 out of 54 (<2%) patients with mild or no gastritis was found histologically positive for Hp, this infection could be detected in 14 (74%) out of 19 patients with moderate to marked gastritis. Conclusion: Moderate to marked gastric mucosa inflammation in gallstone patients is mainly caused by Hp infection, whereas gallbladder function is not related to the degree of gastritis. Thus, an increased alkaline duodenogastric reflux in gallstone patients seems to be of limited pathophysiological relevance.

Helicobacter pylori DNA in gallbladder tissue of patients with cholelithiasis and cholecystitis

“…While Silva et al [11] reported earlier that even though their findings pointed toward a real association between H. pylori infection and cholecystitis, they did not rule out the possibility that H. pylori colonized a previously damaged epithelium. Stathopoulos et al [15] have investigated the relation of gallbladder function and H. pylori infection to gastric mucosa inflammation in patients with symptomatic gallstones prior to cholecystectomy and reported that the gallbladder function is not related to the degree of gastritis. So it appears that several important factors and requirements have to be met in order to establish a definitive association between the presence of H. pylori and biliary diseases.…”

Gallstone Disease and Microbiome

“…However, Griniatsos et al [ 83 ], in contrast, consider that H. pylori does not have a lithogenic potential for the formation of cholesterol gallstones. Stathopoulos et al [ 84 ] suggest that H. pylori infection may affect gallbladder function, namely leading to a decrease in concentration ability.…”

A New Strategy of Minimally Invasive Surgery for Cholecystolithiasis: Calculi Removal and Gallbladder Preservation

“…Cholecystectomy is the main treatment method for gallstones, but various complications exist. With the recognition of the importance of gallbladder function and the side effects of cholecystectomy, experts are increasingly advocating conservation of gallbladder function [3]. Procedures used in the past, such as percutaneous cholecystolithotomy, percutaneous cholecystostomy, extracorporeal shockwave lithotripsy, and dissolution therapy, have limitations, such as continued gallstone recurrence [4].…”