Liver, Pancreas, and Biliary TractHepatic Helicobacter species identified in bile and gallbladder tissue from chileans with chronic cholecystitis☆,☆☆
Section snippets
Patient population
Twenty-three bile and 23 gallbladder tissue specimens were obtained (in 1992, 1993, and 1995) immediately after cholecystectomy. Gallbladder tissues were analyzed from 18 women ranging in age from 19 to 74 years (mean age, 41) and 5 men ranging in age from 21 to 60 years (mean age, 40). Bile samples were analyzed from 21 female (mean age, 37) and 2 male patients, 34 and 40 years old. All patients had clinical signs compatible with chronic cholecystitis, namely, complaints of chronic pain in the
Culture
Despite using several types of Helicobacter-selective media and prolonged incubation under microaerobic conditions, Helicobacter sp. were not cultured from the frozen bile or gallbladder tissues.
Histopathology
Of the 18 specimens examined in detail, all had chronic cholecystitis with mononuclear cell infiltrate in the stroma. None of the gallbladders had evidence of parasitic infection. In 14 cases, there was a mild to moderate degree of infiltration by polymorphonuclear leukocytes. In 9 cases there was
Discussion
The lack of recovery of Helicobacter isolates in this study is not surprising given the prolonged freezer storage of tissue and bile without glycerol or other preservatives. Direct culture of clinical samples should be expected to greatly increase the probability of in vitro Helicobacter isolation and identification.
Despite the difficulty of obtaining PCR amplicons from bile-containing tissue,21 a substantial number of samples were successfully amplified with Helicobacter-specific primers. As
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Address requests for reprints to: James G. Fox, D.V.M., Division of Comparative Medicine, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 45-106 Cambridge, Massachusetts 02139-4307. e-mail: [email protected]; fax: (617) 258-5708.
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Supported by grants CA-67529 and CA-26731 (to J.G.F.) and CA-28842 (to I.R.) from the National Cancer Institute, grant RR-01046 from the National Center for Research Resources (to J.G.F.), and grants DE-10374 and DE-11443 from the National Institute of Dental Research (to F.E.D. and B.J.P.).