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Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: a 36-case series

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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.

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Author information

Authors and Affiliations

  1. Department of General and Thoracic Surgery, Virginia Mason Medical Center, 1100 Ninth Ave. C6-SUR, Seattle, WA, USA

    Mustapha A. el Lakis

  2. Department of General Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy

    Agostino Pozzi

  3. Department of Surgery, Washington University in Saint Louis, Saint Louis, MO, USA

    Jad Chamieh

  4. Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon

    Bassem Safadi

Authors
  1. Mustapha A. el Lakis
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  2. Agostino Pozzi
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  3. Jad Chamieh
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  4. Bassem Safadi
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Corresponding author

Correspondence to Mustapha A. el Lakis.

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Disclosures

Mustapha A. el Lakis, Agostino Pozzi, Jad Chamieh, and Bassem Safadi have no conflicts of interest or financial ties to disclose.

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el Lakis, M.A., Pozzi, A., Chamieh, J. et al. Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: a 36-case series. Surg Endosc 31, 1005–1011 (2017). https://doi.org/10.1007/s00464-016-5078-4

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