Periodontitis as a potential predisposing factor for gallstone cholecystitis: exploring the role of chronic systemic inflammation.

PURPOSE: Periodontitis is a chronic oral disease that contributes to low-grade systemic inflammation and may predispose to extraoral complications. We conducted this study to analyze its association with gallstone-related cholecystitis.

METHODS

The subjects of this prospective observational study were 160 adults with acute calculous cholecystitis or symptomatic cholelithiasis. The patients were grouped according to their periodontal status as having “normal/mild” or “moderate/severe” peridontitis. We calculated the inflammatory indices: the lymphocyte-to-C-reactive protein ratio (LCR), neutrophil-to-lymphocyte ratio (NLR), derived NLR (d-NLR), and platelet-to-lymphocyte ratio (PLR); and analyzed the associations between periodontal status, inflammatory markers, and gallbladder pathology, using univariate and multivariate models.

RESULTS

Moderate/severe periodontitis was found significantly more frequently in patients with cholecystitis than in those with uncomplicated gallstones (80% vs. 22.5%, p < 0.001). Patients with cholecystitis had lower LCR and higher NLR, d-NLR, and PLR values (all p < 0.05). Multivariate analysis identified periodontitis (HR = 1.797) and all inflammatory markers as independent predictors of cholecystitis. Severe periodontitis was especially prevalent in patients with active acute cholecystitis.

CONCLUSION

Periodontitis is significantly associated with acute cholecystitis, potentially through systemic inflammatory mechanisms. Thus, periodontal evaluation may be important in the management and prevention of biliary tract complications.