Abstract

Background: Gallstone disease is a global health problem with multifactorial etiology. In recent years, Helicobacter pylori has been suggested as a possible contributor to gallstone pathogenesis. This study investigates the association between H. pylori infection and gallstone disease in patients undergoing cholecystectomy. Findings demonstrate a significant correlation, suggesting that H. pylori may act as an additional risk factor for gallstone formation. Objective: To investigate the association between Helicobacter pylori infection and gallstone disease by detecting the presence of H. pylori in gallbladder tissue of patients undergoing cholecystectomy, and to evaluate its potential role as a risk factor in gallstone pathogenesis. Methods: This was a prospective observational study conducted at the Department of General Surgery, Sardar Patel Medical College, Bikaner. Patients admitted with gallstone disease who underwent elective or emergency cholecystectomy were included for Giemsa staining. Results: Out of all patients (50 patients) with gallstones, a significant proportion (approx. 40–45%) tested positive for H. pylori. Infection rates were higher in females compared to males. Mixed-type gallstones were more commonly associated with H. pylori positivity than pure cholesterol stones. Patients with H. pylori infection reported more frequent biliary colic episodes and chronic cholecystitis changes in histology. Conclusion: This study demonstrates a significant association between H. pylori infection and gallstone disease. The findings support the hypothesis that H. pylori may serve as a contributing factor in gallstone pathogenesis. Routine evaluation for H. pylori in patients with cholelithiasis may help refine management strategies. Contribution: This study adds clinical evidence from an Indian population to the global debate on H. pylori and gallstone disease. It emphasizes the need to consider infectious etiology in gallstone pathogenesis alongside traditional risk factors. The findings may encourage future trials exploring whether H. pylori eradication can reduce recurrence of gallstone disease.

• 1.   Figura N., Moretti E., et al. Helicobacter pylori infection and gallstones: A systematic review. World J Gastroenterol. 2014; 20(19): 6395–6403. doi:10.3748/wjg.v20.i19.6395
• 2.   Abayli B., et al. Detection of Helicobacter pylori DNA in gallstones and gallbladder tissue. World J Gastroenterol. 2005; 11(5): 737–740. doi:10.3748/wjg.v11.i5.737
• 3.   Apostolov E., et al. H. pylori in the biliary tract as a risk factor for gallstone disease. Eur J Gastroenterol Hepatol. 2005; 17(2): 195–201. doi:10.1097/00042737-200502000-00012
• 4.   Chen W., et al. Association between H. pylori infection and biliary diseases: A meta-analysis. World J Gastroenterol. 2015; 21(46): 13486– 13494. doi:10.3748/wjg.v21.i46.13486
• 5.   Fox JG, et al. Helicobacter species in the biliary tract and their role in cholecystitis. J Infect Dis. 1998; 177(6): 1614–1621. doi:10.1086/515314
• 6.   Attaallah W., et al. H. pylori and gallstone disease: Evidence from cholecystectomy specimens. Clin Res Hepatol Gastroenterol. 2011; 35(9): 594–598. doi:10.1016/j. clinre.2011.03.015
• 7.   Shukla V.K., et al. Role of H. pylori in gallbladder disease. Indian J Gastroenterol. 2001; 20(4): 167–169. PMID:11569641
• 8.   Karagin P., et al. The relationship between H. pylori infection and gallstone formation: a clinical study. Dig Dis Sci. 2010; 55(1): 104–108. doi:10.1007/s10620-009-0788-7Baek JH, Na DG, Lee JH, Jung SL, Kim JH, Sung JY, et al.
• 9.   Nilsson H.O., et al. Presence of H. pylori in gallbladder mucosa. Gut. 2000; 46(5): 629–632. doi:10.1136/gut.46.5.629
• 10.   Pandey M., et al. Association of H. pylori and gallbladder cancer. World J Gastroenterol. 2006; 12(35): 5832–5835. doi:10.3748/wjg.v12. i35.5832
• 11.   Chen D.F., et al. H. pylori DNA detection in biliary diseases: Evidence from PCR studies. BMC Gastroenterol. 2010; 10: 80. doi:10.1186/1471-230X-10-80
• 12.   Osawa H., et al. Relationship between H. pylori infection and gallstones in Japanese patients. J Gastroenterol. 2005; 40(4): 325–331. doi:10.1007/s00535-005-1545-y
• 13.   Kakaei F., et al. H. pylori colonization and gallstone composition. Hepatobiliary Pancreat Dis Int. 2009; 8(5): 507–510. PMID:19822477
• 14.   Zhang Y., et al. Meta-analysis of H. pylori and gallstone disease. PLoS One. 2015; 10(3): e0120921. doi:10.1371/journal.pone.0120921

Data Sharing Statement

Funding