title: Does Helicobacter pylori identification in the mucosa of the gallbladder correlate with cholesterol gallstone formation?
abstract: OBJECTIVE
  Helicobacter pylori (H pylori) represents a potential initiator of cholesterol crystallization and it has been proposed that it is related to gallstone formation. In this study, any possible association between the H pylori identification in the mucosa of gallbladder and cholesterol gallstone formation was evaluated
  
  
  METHODS
  Gallbladders containing pure or mixed cholesterol gallstones (cholelithiasis group, n = 89) and gallbladders without gallstones (control group, n = 42) were submitted to standard histopathological examination for H pylori detection, as well as to nested polymerase chain reaction amplification for H pylori DNA detection.
  
  
  RESULTS
  Helicobacter pylori was identified in the gallbladder's epithelium in four patients with cholelithiasis and in two patients in the control group by histology. In all the cases which were found to be H pylori positive by histological examination, H pylori DNA were also detected. No correlation between gallstone formation and H pylori detection in the biliary epithelium was found. A higher incidence of acute inflammation in the cholelithiasis (22.5% vs 9.5%, p = not significant [ns]) and in the H pylori positive groups (33% vs 17.6%, p = ns) were histologically detected. A higher incidence (10% vs 0%), p = ns) of H pylori in gallbladders with gallstones and acute inflammation, compared to gallbladders with acute inflammation but without gallstones, was noticed
  
  
  CONCLUSIONS
  Helicobacter pylori is detectable in low frequency in the mucosa of the gallbladder and it does not seem to act as a lithogenic component for cholesterol gallstone formation. Its higher incidence in gallbladders with gallstones and acute inflammation, suggests a possible accessory role in a subset of patients with cholelithiasis.
authors.affiliation: First Department of Surgery, University of Athens, Medical School, Laiko Hospital, GR 115-27, Athens, Greece. johngriniatsos@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: Griniatsos
authors.forename: S
authors.initials: S
authors.lastname: Sougioultzis
authors.forename: K
authors.initials: K
authors.lastname: Giaslakiotis
authors.forename: M
authors.initials: M
authors.lastname: Gazouli
authors.forename: E
authors.initials: E
authors.lastname: Prassas
authors.forename: E
authors.initials: E
authors.lastname: Felekouras
authors.forename: O
authors.initials: O
authors.lastname: Michail
authors.forename: E
authors.initials: E
authors.lastname: Avgerinos
authors.forename: E
authors.initials: E
authors.lastname: Pikoulis
authors.forename: G
authors.initials: G
authors.lastname: Kouraklis
authors.forename: I
authors.initials: I
authors.lastname: Delladetsima
authors.forename: M
authors.initials: M
authors.lastname: Tzivras
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005704:Gallbladder / Q000382:microbiology*; D042882:Gallstones / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006651:Histocytochemistry; D006801:Humans; D007413:Intestinal Mucosa / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
chemical_list: D004269:DNA, Bacterial