Urolithiasis after Intestinal Bypass for Morbid Obesity-Chinese Experience

小腸繞道手術後之尿路結石

邱文祥(Allen Wen-Hsiang Chiu) ； 陳明村(Ming-Tsun Chen) ； 李瀛輝(Ying-Huei Lee) ； 張心湜(Luke S. Chang) ； 黃榮慶(Jong-Khing Huang) ； 單子元(Tzyy-Yuan Shann) ； 彭芳谷(Fang-Ku P' Eng)

《中華民國泌尿科醫學會雜誌》 1卷2期 (1990/06) Pp. 105-110

https://doi.org/10.7024/JUAROC.199006.0105

摘要

Jejunoileal bypass for decreasing morbid obesity has been advocated by Kremen for more than 25 years. Not unexpectedly, obese patients in whom an intestinal bypass had been created have had multiple metabolic problems directly related to their surgical procedure, such as diarrhea, liver insufficiency, gall stone and urolithiases. The reported incidence of urinary tract stone was form 2% to 23%, and most of these stones were composed of calcium oxalate. From February 1947 to February 1986, a total of 65 morbid obese patients received the jejunoileal bypass at Veterans General Hospital, Taipei. Four of them (6.1%) suffered from urolithiasis after an unusual average duration of 100 months postoperatively, which is much longer than the western reports. The stone analyses were all composed of calcium oxalate. Seventeen of these 65 patients were reevaluated with urine analysis and intravenous urography for detecting the urolithiasis; the urine and blood were also sampled for the measurement of calcium, uric acid, magnesium, inorganic phosphate and oxalate. There was a significant increment of 24-hour urine oxalate in morbid obese patients as compared with the control group (51.4 ± 18.7 mg/day vs. 21.1 ± 13.6 mg/day，P value ＜0.0005), and abnormal urine oxalate level was found in 8 patients (47%). Nevertheless, other urine or serum concentration of calcium, uric acid, magnesium or phosphate showed no statistically significant difference in these two groups.
(J Urol R.O.C., 1: 105-110, 1990)

並列摘要

Jejunoileal bypass for decreasing morbid obesity has been advocated by Kremen for more than 25 years. Not unexpectedly, obese patients in whom an intestinal bypass had been created have had multiple metabolic problems directly related to their surgical procedure, such as diarrhea, liver insufficiency, gall stone and urolithiases. The reported incidence of urinary tract stone was form 2% to 23%, and most of these stones were composed of calcium oxalate. From February 1947 to February 1986, a total of 65 morbid obese patients received the jejunoileal bypass at Veterans General Hospital, Taipei. Four of them (6.1%) suffered from urolithiasis after an unusual average duration of 100 months postoperatively, which is much longer than the western reports. The stone analyses were all composed of calcium oxalate. Seventeen of these 65 patients were reevaluated with urine analysis and intravenous urography for detecting the urolithiasis; the urine and blood were also sampled for the measurement of calcium, uric acid, magnesium, inorganic phosphate and oxalate. There was a significant increment of 24-hour urine oxalate in morbid obese patients as compared with the control group (51.4 ± 18.7 mg/day vs. 21.1 ± 13.6 mg/day，P value ＜0.0005), and abnormal urine oxalate level was found in 8 patients (47%). Nevertheless, other urine or serum concentration of calcium, uric acid, magnesium or phosphate showed no statistically significant difference in these two groups.
(J Urol R.O.C., 1: 105-110, 1990)

並列關鍵字

urolithiasis ； jejunoileal bypass ； morbid obesity