Nephrolithiasis after bariatric surgery: A comparison of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy

Am J Surg. 2020 Jun;219(6):952-957. doi: 10.1016/j.amjsurg.2019.09.010. Epub 2019 Sep 20.

Abstract

Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is known to increase risk for calcium oxalate nephrolithiasis due to hyperoxaluria; however, nephrolithiasis rates after laparoscopic sleeve gastrectomy (LSG) are not well described. Our objective was to determine the rate of nephrolithiasis after LRYGB versus LSG.

Methods: The electronic medical records of patients who underwent LRYGB or LSG between 2001 and 2017 were retrospectively reviewed.

Results: 1,802 patients were included. Postoperative nephrolithiasis was observed in 133 (7.4%) patients, overall, and 8.12% of LRYGB (122/1503) vs. 3.68% of LSG (11/299) patients (P < 0.001). Mean time to stone formation was 2.97 ± 2.96 years. Patients with a history of UTI (OR = 2.12, 95%CI 1.41-3.18; P < 0.001) or nephrolithiasis (OR = 8.81, 95%CI 4.93-15.72; P < 0.001) were more likely to have postoperative nephrolithiasis.

Conclusion: The overall incidence of symptomatic nephrolithiasis after bariatric surgery was 7.4%. Patients who underwent LRYGB had a higher incidence of nephrolithiasis versus LSG. Patients with a history of stones had the highest risk of postoperative nephrolithiasis.

Keywords: Bariatric surgery; Gastric bypass; Hyperoxaluria; Nephrolithiasis; Sleeve gastrectomy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Female
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Gastric Bypass / adverse effects*
  • Gastric Bypass / methods
  • Humans
  • Incidence
  • Laparoscopy*
  • Male
  • Middle Aged
  • Nephrolithiasis / epidemiology*
  • Nephrolithiasis / etiology*
  • Postoperative Complications / etiology*
  • Retrospective Studies