Outcome of H. Pylori Infection of Gallbladder Mucosa in Patients of Chronic Cholecystitis

Abstract

Background: The association between H. pylori and biliary tract disease has been investigated but not clearly demonstrated. Presence of H. pylori in the biliary tree of few individuals has led to the conjecture that it is a cause of gallbladder disease.
Objectives: To study association between chronic cholecystitis and H pylori infection in gallbladder mucosa and compare clinical and histopathological features between H pylori positive and negative chronic cholecystitis patients.
Material and Methods: The study entailed comprised of 50 patients admitted for cholecystectomy. The study was carried out in Postgraduate Department of Surgery, G.M.C. & Hospital, Jammu over a period of one year (1^st Nov. 2018 - 31^st Oct. 2019). Detailed history and clinical examination were performed with assessment of biochemical, hematological and radiological parameters after obtaining written informed consent. All patients were subjected to urea breath test and H. pylori stool antigen test to detect H. pylori in their gastrointestinal tract pre-operatively. After cholecystectomy and gross examination of specimen, two biopsies each were taken from fundus, body and neck of gallbladder for histopathology and microbiological studies.
Results: Patients undergoing cholecystectomy with colonization of gallbladder mucosa with H. pylori are likely to have a higher frequency of heartburn with higher incidence of thickened gallbladder containing multiple stones and contracted gallbladder on USG and intraoperatively a difficult gallbladder with evidence of features of chronic cholecystitis on histopathology.
Conclusion: The observations noted in this study highlight the need to take appropriate preventive and eradicative measures for H. pylori in the gallbladder.