Metallic staples refluxing to the upper urinary tract: a source of renal calculi in patients with ileal conduit urinary diversion

Abstract

Surgical stapling devices to close the proximal end of the isolated loop of an ileal urinary conduit have been used since the early 1970s (Assadnia et al, 1972). However, the occasional development of calculi forming around the metal staples has deterred uniform acceptance of this technique in spite of its advantages of speed and decreased post-operative morbidity (Assadnia et al, 1972; Bergman et al, 1978). We describe two patients who presented to this hospital in recent months, in whom surgical staples migrated proximally into the renal pelvis, becoming the nidus for stone formation in one of the patients.

Gallstone ileus 20 years after a Kasai procedure using a stapled antireflux valve

“…First, the staple line is lithogenic. There is evidence of similar processes of stone formation occurring in patients that have undergone urinary tract reconstructions with stapled antireflux valves [5]. Second, the proximal dilation of the Roux limb was owing to the presence of a relatively nondilatable annular valve leading to an environment of bacterial overgrowth, which would also be lithogenic.…”