Helaly G F, El-Ghazzawi E F, Kazem A H, Dowidar N L, Anwar M M, Attia N M
Br J Biomed Sci. 2014;71(1):13-8. doi: 10.1080/09674845.2014.11669957.
Reports of Helicobacter pylori in biliary tract diseases in humans are very fragmentary, and therefore there is a need for further investigations. This study aims to detect H. pylori in the bile and gall bladder (GB) of patients with chronic calcular cholecystitis (CCC), and to determine the association of H. pylori infection with gallstone type. Thirty patients with CCC admitted for laparoscopic cholecystectomy were investigated, including upper gastro-endoscopy before cholecystectomy. Rapid urease test and histopathological examination were performed on gastric biopsies. The GB specimens were investigated for the presence of H. pylori by immunohistochemistry (IHC). H. pylori antigen in bile was detected by enzyme immunoassay. Chemical analysis of gallstones was performed to determine type. Immunohistochemistry testing showed 73.3% and 66.7% positivity among GB neck and body biopsies, respectively, demonstrating high sensitivity and specificity. A significant association was found between gastric and GB H. pylori positivity (P < 0.01). H. pylori antigen was detected in bile from three CCC cases. The greatest number of stones were of the calcium bilirubinate type. Gall bladder positivity for H. pylori was accompanied by chronic quiescent gastritis (40.9%). In conclusion, H. pylori infection may be an aetiological factor leading to cholecystitis. Gastric colonisation with H. pylori could be a source for GB infection, and the organism may act as a lithogenic component, especially in the context of pure pigmented gallstones.
关于人类胆道疾病中幽门螺杆菌的报道非常零散，因此有必要进行进一步研究。本研究旨在检测慢性结石性胆囊炎（CCC）患者胆汁和胆囊（GB）中的幽门螺杆菌，并确定幽门螺杆菌感染与胆结石类型之间的关联。对30例因腹腔镜胆囊切除术入院的CCC患者进行了调查，包括胆囊切除术前的上消化道内镜检查。对胃活检组织进行快速尿素酶试验和组织病理学检查。通过免疫组织化学（IHC）检测GB标本中是否存在幽门螺杆菌。采用酶免疫分析法检测胆汁中的幽门螺杆菌抗原。对胆结石进行化学分析以确定类型。免疫组织化学检测显示，GB颈部和体部活检的阳性率分别为73.3%和66.7%，具有较高的敏感性和特异性。发现胃和GB幽门螺杆菌阳性之间存在显著关联（P < 0.01）。在3例CCC患者的胆汁中检测到幽门螺杆菌抗原。结石数量最多的是胆红素钙型。GB幽门螺杆菌阳性伴有慢性静止性胃炎（40.9%）。总之，幽门螺杆菌感染可能是导致胆囊炎的一个病因。幽门螺杆菌在胃中的定植可能是GB感染的一个来源，并且该菌可能作为致石成分，尤其是在纯色素性胆结石的情况下。
