Prevalence of <i>Helicobacter pylori</i> and Nonulcer Dyspepsia in Patients with Gallstones before and after a Cholecystectomy

Yoon, Yong Bum; Ryu, Ji Kon; Lee, Han Chu; Kim, Yong Tae; Kim, Chung Yong; Kim, Sun Whe

Korean J Pancreas Biliary Tract > Volume 3(1): > Article

Original Article

담낭담석 환자에서 담낭절제술이 Helicobacter pylori 유병률과 비궤양성 소화불량 증상에 미치는 영향

윤용범¹, 류지곤¹, 이한주¹, 김용태¹, 김정룡¹, 김선회²

¹서울대학교 의과대학 내과학교실, 간연구소
²서울대학교 의과대학 외과학교실

Prevalence of Helicobacter pylori and Nonulcer Dyspepsia in Patients with Gallstones before and after a Cholecystectomy

Yong Bum Yoon¹, Ji Kon Ryu¹, Han Chu Lee¹, Yong Tae Kim¹, Chung Yong Kim¹, Sun Whe Kim²

¹Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
²Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

Corresponding author: Yong Bum Yoon,

ABSTRACT

Background/Aims:
Patients with gallstones may be asymptomatic or may complain of biliary colic and various dyspeptic manifestations. These dyspeptic symptoms are occasionally relieved in some patients after a cholecystectomy while they may persist in other patients. Helicobacter pylori(H. pylori) is known to induce peptic ulcers, but the relationship between H. pylori and nonulcer dyspepsia is still being debated. After a gastric operation, the prevalence of H. pylori is decreased and this decrease is attributed to an increased concentration of bile salts, resulting from increased duodenogastric reflux in the gastric juice, in these patients. A cholecystectomy also increases duodenogastric reflux, but whether the prevalence of H. pylori is influenced by a cholecystectomy is still unknown. In our study, we tried to assess prospectively the dyspeptic symptoms before and after a cholecystectomy in the change of prevalence of H. pylori and in patients with gallstones.
Methods:
Patients with gallstones and biliary colic were included. Patients who had peptic ulcers, CBD stones, or acute cholecystitis and who were given antibiotics after the cholecystectomy were excluded. The H. pylori status was examined by histology and a CLO test and the dyspeptic symptoms were evaluated by using questionnaires completed before and 3 months after the laparoscopic cholecystectomy.
Results:
Thirty two patients with gallstones were considered and the mean age was 49 years; there were 9 men and 23 women. The prevalence of H. pylori was 69% and did not change after the cholecystectomy. Before the cholecystectomy, 25 patients complained of 1 or more dyspeptic symptoms, and the prevalence of nausea, vomiting, indigestion, heartburn, belching, and epigastric pain were 31%, 6%, 50%, 41%, 34% and 31%, respectively. After the cholecystectomy, the dyspeptic symptoms were improved in 12 patients(48%), but symptom improvement was not related with the H. pylori status.
Conclusions:
H. pylori is not related with dyspeptic symptoms in patients with gallstones, and the prevalence of H. pylori is not changed by a cholecystectomy.

Keywords: Helicobacter pylori, Gallstones, Cholecystectomy, Nonulcer dyspepsia