The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis

Abstract

Helicobacter pylori (H. pylori) is proved to be the main pathogenic agent of various diseases, including chronic gastritis, gastric ulcer, duodenal ulcer, and gastric cancer. In addition, chronic cholecystitis and cholelithiasis are common worldwide, which are supposed to increase the total mortality of patients. Epidemiologic evidence on the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis still remains unclear. We conducted a systematic review and meta-analysis of overall studies to investigate the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis. Two researchers searched PubMed, Embase, and Cochrane Library databases to obtain all related and eligible studies published before July 2020. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated by the random-effects model. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also conducted. Twenty studies were included in the meta-analysis, involving 1735 participants and 1197 patients with chronic cholecystitis/cholelithiasis. Helicobacter species infection of the gallbladder was positively correlated with increased risk of chronic cholecystitis and cholelithiasis, especially H. pylori (OR = 3.05; 95% CI, 1.81–5.14; I2 = 23.5%). Besides, country-based subgroup analysis also showed a positive correlation between the gallbladder H. pylori positivity and chronic cholecystitis/cholelithiasis risk. For Asian and non-Asian country studies, the ORs were 4.30 (95% CI, 1.76–10.50; I2 = 37.4%) and 2.13 (95% CI, 1.23–3.70; I2 = 0.0%), respectively. The association was more obvious using the bile sample and urease gene primer. In conclusion, this meta-analysis provided evidence that there is a positive correlation between H. pylori infection in the gallbladder and increased risk of chronic cholecystitis and cholelithiasis.

Study of association of H. pylori infection of the gall bladder and calculous cholecystitis

“…Among those having H. pylori majority were females. (p=0.23) similar results were found by Liang Wang et al [11] where they showed that female gender was not statistically significant. In Our study No statistical significance was seen between H. pylori and type of stone.…”

“…Data analysis was done using and open epi version 2.3.1. [11] showed that risk of gallstone diseases increases with age in all racial groups. Because of female sex hormones and increased cholesterol secretion, females with obesity are more likely to get gallstones.…”

“…In Our study 5.6% H. pylori was present in gall bladder mucosa. Liang Wang et al [11] showed that 23.6% had H. pylori infection. Fatemi SM et al [13] showed that 8% had positive H. pylori report.…”

The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease

“…Acute cholecystitis is the most frequent complication of symptomatic gallstone disease and in 90% of cases is caused by occlusion of the cystic duct, though the neck of the gallbladder may also be occluded [ 17 , 18 ]. Occlusion is usually accompanied by inflammation that in some cases may be bacterial [ 19 ], particularly with H. pylori [ 20 ]. The characteristic sharp continuous pain of symptomatic cholelithiasis is known as biliary colic (BC).…”

Modern Clinical Course of Cholelithiasis in the Far North

“…After 70 years, gender differences in incidence disappear, the incidence gradually increases and reaches 30-40 %. Publications of clinical observations of foreign and domestic literature indicate that in the last 45-50 years the incidence of cholecystitis doubles every 10 years, and the clinic is characterized by diversity and atypical course [17][18][19][20][21][22][23]. Ultrasound showed a fairly high diagnostic capability in the diagnosis of cholecystitis.…”