Detection of Helicobacter pylori in the Human Biliary Tree

Shim, Ki Nam; Myung, Seung Jae; Kim, Myung Hwan; Kim, Hong Ja; Park, Eun Taek; Yoo, Kyo Sang; Min, Byeong Cheol; Seo, Dong Wan; Lee, Sung Koo; Min, Young Il; Kim, Ji Yeon

Abstract

BACKGROUND/AIMS: Recently several authors have reported that H. pylori DNA could be found in the bile of patients with diseased bile duct. The aim of this study was to investigate the existence of H. pylori in the biliary system including bile, biliary epithelium and gallstones.
METHODS
Forty-three intrahepatic bile and bile duct tissue samples were obtained by percutaneous transhepatic cholangioscopy (PTCS group). Additionally, 31 gallbladder bile and gallbladder tissue samples were obtained during cholecystectomy (CCT group, 23 cases) and from incidental cholecystectomy (control group, 8 cases). H. pylori DNA was examined using 26 kDa surface protein antigen and urease A gene primer. In 7 cases of hepatolithiasis, the DNA was extracted from the gallstones by subsequent H. pylori polymerase chain reaction (PCR). The direct sequencing of the PCR products, the chemical composition and pH of intrahepatic bile were analyzed.
RESULTS
For 43 PTCS group, PCR showed positivity in 4 cases (9.3%) when 26 kDa surface protein antigen primer was used, but in 5 cases (11.6%) when urease A gene primer was used. H. pylori DNA was detected in only one bile duct tissue sample (2.3%).
CONCLUSIONS
We concluded that H. pylori DNA could be detected in the biliary tree. Further investigation will be required to ascertain the role of H. pylori in the human biliary tree.