The link between Helicobacter pylori infection and gallbladder and biliary tract diseases: A review

Abstract

Helicobacter pylori is a gram-negative pathogen commonly associated with peptic ulcer disease and gastric cancer. H. pylori infection has also been reported in cholelithiasis, cholecystitis, gallbladder polyps, and biliary tract cancers. However, the association between H. pylori and gallbladder and biliary tract pathologies remains unclear due to the paucity of literature. In response to the current literature gap, we aim to review and provide an updated summary of the association between H. pylori with gallbladder and biliary tract diseases and its impact on their clinical management. Relevant peer-reviewed studies were retrieved from Medline, PubMed, Embase, and Cochrane databases. We found that H. pylori infection was associated with cholelithiasis, chronic cholecystitis, biliary tract cancer, primary sclerosing cholangitis, and primary biliary cholangitis but not with gallbladder polyps. While causal links have been reported, prospective longitudinal studies are required to conclude the association between H. pylori and gallbladder pathologies. Clinicians should be aware of the implications that H. pylori infection has on the management of these diseases.

Exploring the Relationship Between Helicobacter pylori Infection and Biliary Diseases: A Comprehensive Analysis Using the United States National Inpatient Sample (2016-2020)

“…This underscores the capacity of H. pylori's ability to access and persist within the biliary tract. Such capability provides both the avenue and the mechanism for H. pylori, a recognized group 1 carcinogen, to induce chronic inflammation and malignancy in the hepatobiliary system [10]. Mechanistically, H. pylori triggers multiple oncogenic, intracellular pathways within epithelial cells, including phosphoinositide-3-kinase (PI3K), nuclear factor kappa B (NF-κB), and Wnt/β-catenin [25][26][27].…”

“…Common biliary conditions embracing gallstones, cholecystitis, and choledocholithiasis have been linked to H. pylori infection [ 9 ]. Lim et al in their systematic review highlighted the connection between H. pylori and biliary tract diseases, impacting their clinical management [ 10 ]. The authors pinpointed that H. pylori infection was correlated with cholelithiasis (41.5%) and biliary tract cancer (66.7%), although no association was found with gallbladder polyps [ 10 ].…”

“…Lim et al in their systematic review highlighted the connection between H. pylori and biliary tract diseases, impacting their clinical management [ 10 ]. The authors pinpointed that H. pylori infection was correlated with cholelithiasis (41.5%) and biliary tract cancer (66.7%), although no association was found with gallbladder polyps [ 10 ]. In their systematic review involving 2,932 participants, Wang et al identified a significant positive correlation between gallbladder infection with H. pylori and an elevated risk of cholelithiasis and chronic cholecystitis [ 9 ].…”

“…Prior reviews and studies on the relationship between H. pylori infection and biliary tract diseases have faced constraints, including inadequate control of confounding factors and small sample sizes that may not adequately represent the broader population [ 6 , 9 , 10 ]. Furthermore, certain studies have failed to identify any association [ 11 ].…”

“…Furthermore, certain studies have failed to identify any association [ 11 ]. Given the increased mortality and morbidity risk associated with biliary diseases, understanding the relationship between H. pylori and biliary tract disorders is crucial for effective management [ 10 ].…”