Helicobacter pylori and Symptomatic Cholelithiasis: Correlation Between Rapid Urease Testing and Histopathological Findings

Background: Symptomatic cholelithiasis represents a substantial healthcare burden, with accumulating evidence implicating Helicobacter pylori in pathogenesis; however, its preoperative detection merits validation in surgical populations. Methods: Prospective ambispective observational study conducted at a tertiary care center in South India, enrolled 67 patients aged 12-70 years undergoing elective cholecystectomy for ultrasound-confirmed symptomatic gallstones. Preoperative rapid urease testing assessed H. pylori status, with postoperative histopathology serving as reference standard. IBM SPSS Statistics v29.0 analyzed demographics, comorbidities, family history, postoperative outcomes (hospital stay, VAS scores, complications) and diagnostic metrics (sensitivity, specificity, ROC-AUC). Reporting adhered to STROBE guidelines. Results: Participants were predominantly female (67.2%) and middle-aged (46-60 years: 34.3%). Comorbidities included diabetes mellitus (44.8%), hypothyroidism (34.4%), hypertension (25.4%) and family history of gallstones (43.3%). H. pylori prevalence was 52.2% by histopathology (preoperative urease positivity: 55.2%), yielding sensitivity 95%, specificity 83% and AUC 0.95. Mean hospital stay measured 5.76 ± 1.43 days; VAS pain scores declined from 5.78 ± 2.45 postoperatively to 3.27 ± 0.82 at 30 days, accompanied by surgical site infection (32.8%) and peritonitis (44.8%). Conclusion: Substantial H. pylori prevalence underscores the rapid urease test’s high diagnostic accuracy for preoperative screening in cholelithiasis, facilitating targeted eradication amid metabolic risk factors; multicentre validation trials are indicated.