Helicobacter Pylori-Related Gall Bladder Diseases A Surgical View

Abstract

ABSTRACT
Background: Approximately 700,000 cholecystectomies are performed annually in the
United States. Post cholecystectomy syndrome occurs in about 5 to 40%. Helicobacter
pylori have been detected in bile, liver and biliary epithelium obtained from patients with
hepatobiliary diseases. These finding highlight the need to study the role of this bacterium
in the genesis of biliary diseases and post cholecystectomy syndrome.
Objectives: To study the relation of Helicobacter pylori in post cholecystectomy syndrome
and the need for screening program aiming in prevention or early detection of gall bladder
disease with ultimate decline in rate of cholecystectomy.
Methods: A cross sectional study conducted at Al-Kindy Teaching Hospital from May
2013 to March 2015 that involved 103 patients underwent cholecystectomy.
Results: Thirty two (31.06%) out of (103) total patients came back complaining of
persistent pain in right upper abdomen with time ranged from immediate post-operative to
five weeks after surgery. All relevant investigations revealed no apparent surgical
sequelae and diagnosis of post cholecystectomy syndrome was made. Twenty nine out of
those thirty two showed positive stool for Helicobacter pylori antigen. Eradication therapy
started and showed dramatic alleviation of pain with no relapse for all yet.
Conclusion: Testing stool for Helicobacter pylori antigen in patients with post
cholecystectomy syndrome is recommended hence it is simple, non-invasive, non-costly
with high sensitivity rate and available in most centers and eradication of Helicobacter
pylori is one of suggested treatment option for post cholecystectomy syndrome. A
screening program concerning this bacterium is recommended for prevention or early
detection of gall bladder diseases to avoid cholecystectomy and use other modality of
treatment.