Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: a 36-case series
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Springer New York LLC
Abstract
Background: Portomesenteric vein thrombosis following laparoscopic bariatric surgical procedures is a serious and potentially lethal complication. It is quite rare, and its clinical presentation, management, and sequelae remain poorly understood. Methods: We searched PubMed, Medline, Google Scholar, Ovid, and Cochrane databases for articles reporting case series and systematic reviews in the English language on patients who underwent laparoscopic bariatric surgery and had a subsequent portal or mesenteric vein thrombosis. Articles discussing laparoscopic gastric banding were excluded. Results: A total of 14 articles reporting on 36 cases were found. We analyzed the pooled data from these case reports and series with emphasis on number of reported patients, demographics, time of diagnosis, risk factors, symptoms, management, complications, and sequelae. Conclusions: Portomesenteric vein thrombosis is not uncommon following laparoscopic bariatric surgery and appears to occur more after laparoscopic sleeve gastrectomy. Bariatric surgeons should have a high index of suspicion for early detection and treatment of this potentially lethal complication. Obese patients at high risk for venous thrombosis should be screened for genetic predisposition for hypercoagulable state and should be considered for extended thromboprophylaxis postoperatively. © 2016, Springer Science+Business Media New York.
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Bariatric surgery, Laparoscopy, Mesenteric vein thrombosis, Portal vein thrombosis, Gastrectomy, Gastric bypass, Humans, Mass screening, Mesenteric veins, Obesity, morbid, Portal vein, Postoperative complications, Risk factors, Thrombophilia, Venous thrombosis, Acenocoumarol, Electrolyte, Heparin, Low molecular weight heparin, Prothrombin, Warfarin, Abdominal pain, Anticoagulant therapy, Article, Asymptomatic disease, Backache, Bloating, Diarrhea, Dyslipidemia, Gene mutation, Hospitalization, Human, Hypertension, Hypertransaminasemia, Insulin resistance, Laparoscopic sleeve gastrectomy, Laparoscopic surgery, Malaise, Nausea, Non insulin dependent diabetes mellitus, Ovary polycystic disease, Portal hypertension, Postoperative thrombosis, Priority journal, Protein c deficiency, Protein s deficiency, Recanalization, Rest, Roux-en-y gastric bypass, Systematic review, Vein insufficiency, X-ray computed tomography, Gastric bypass surgery, Genetics, Hepatic portal vein, Mesenteric vein, Procedures, Risk factor