Are Helicobacter Pylori and Other Helicobacter Species Infection Associated with Human Biliary Lithiasis? A Meta-Analysis

Abstract

BackgroundSince the isolation of Helicobacter species in biliary system, a hypothetical question was raised about the role of these agents in the development of cholelithiasis. This meta-analysis is to explore the association between the Helicobacter infection and biliary lithiasis.Methodology/Principal FindingsA systematic literature search was performed to identify all eligible articles. Meta-analysis which was carried out using odds ratio and random effect model, 95% confidence intervals for odds ratio was calculated. Quantitative assessment of heterogeneity was explored by chi-square test with significance set at P value 0.10 and was measured using I 2 statistic. Eighteen studies published between 1998 and 2011 were finally eligible for meta-analysis. H. Pylori, H. Bilis, H. Hepaticus, H. Pullorum and H. Ganmani were studied. With heterogeneity (I2 = 69.5%, P<0.0001), significantly higher pooled infection rates of H. Pylori (OR: 2.59, 35.82% versus 26.75%, P = 0.01) and H. Hepaticus (OR: 3.13, 31.30% versus 12.12%, P = 0.02) were observed in lithiasis group. Higher prevalence of H. Pylori in cholelithiasis patients were reported by studies from East Asia, South Asia and South America. Evidences supporting the higher presence of H. Pylori in cholelithiasis patients could be found by PCR for detecting 16s rRNA in bile, 26kDa protein gene in biliary tissue and immunohistochemistry. Using multiple detection tests could increase the detection rate of H. Pylori.Conclusions/SignificancesOur meta-analysis suggests a trend of higher presence of H. Pylori in cholelithiasis patients than control group and this trend was significant in the regions with higher prevalence of this agent. Evidences supporting the association between Helicobacter and cholelithiasis could be found by using different tests but the gold standard for the identification of these bacteria in biliary system has yet to be established. Considering obvious heterogeneity, a large multi-center study will facilitate us to further clarify the association between the Helicobacter infection and cholelithiasis.

A Comparative Study of Clinicopathological Features between Chronic Cholecystitis Patients with and without Helicobacter pylori Infection in Gallbladder Mucosa

“…Our previous meta-analysis demonstrated that Helicobacter pylori ( H.pylori ) in human biliary system was correlated with chronic cholecystitis, especially in the regions with higher prevalence of this infectious agent such as South Asia, East Asia and Latin America. [6] Evidences supporting the association between H.pylori infection and chronic cholecystitis could be found by using direct culture or staining of H.pylori in gallbladder tissues as well as indirect techniques such as PCR, ELISA and serology for detecting H.pylori -specific genes or antibodies [7]–[9]. The positive rate of H.pylori in gallbladder is reported to be 10%–20% by culture.…”

Helicobacter pylori in ice cream and its control using mastic gum essential oil

“…have been identified and several of them are associated with various chronic digestive diseases (Zhou et al, 2011). H. pullorum has been related to diarrhea, gastroenteritis and liver disease in humans (Ceelen et al, 2005).…”

Histomorphological changes in gall bladder diseases and its association with helicobacter infection

“…However, its definite role and relation in the gallbladder diseases have not been well defined. In the meta-analysis published by Zhou et al 26 in 2011, showed that the Helicobacter detection rate in gallbladder to range from 3.02% to 80%. The detection rate varied with the type of methods used.…”