Skip to main content

Thrombo-Prophylaxis and Avoidance of Portal Vein Thrombosis

  • Chapter
  • First Online:
The Perfect Sleeve Gastrectomy

Abstract

Deep venous thrombosis (DVT) and pulmonary thromboembolism (PE) are known and severe postoperative complications and major causes of morbidity and mortality up to 1 year after bariatric surgery. Patients undergoing bariatric surgery should be considered at least at moderate risk for DVT and PE, and pharmacologic prophylaxis reduces the incidence of these thrombotic complications. Portomesenteric vein thrombosis (PVT) is a rare and potentially life-threatening postoperative complication in bariatric surgery with a higher incidence after LSG compared with other bariatric procedures. Extended postoperative pharmacologic prophylaxis reduces the incidence of DVT and PE, may also reduce the incidence of PVT, and should be considered in patients after LSG.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Inaba CS, Koh CY, Sujatha-Bhaskar S, et al. One-year mortality after contemporary laparoscopic bariatric surgery: an analysis of the bariatric outcomes longitudinal database. J Am Coll Surg. 2018;226:1166–74.

    Article  Google Scholar 

  2. Berger ER, Huffman KM, Fraker T, et al. Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the metabolic and bariatric surgery accreditation and quality improvement program. Ann Surg. 2018;267:122–31.

    Article  Google Scholar 

  3. Stieber AC, Zetti G, Todo S, et al. The spectrum of portal vein thrombosis in liver transplantation. Ann Surg. 1991;213:199–206.

    Article  CAS  Google Scholar 

  4. Swartz DE, Felix EL. Acute mesenteric venous thrombosis following laparoscopic Roux-en-Y gastric bypass. JSLS. 2004;8:165–9.

    PubMed  PubMed Central  Google Scholar 

  5. Bellanger DE, Hargroder AG, Greenway FL. Mesenteric venous thrombosis after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2010;6:109–11.

    Article  Google Scholar 

  6. Hassn AM, Al-Fallouji MA, Ouf TI, Saad R. Portal vein thrombosis following splenectomy. Br J Surg. 2000;87:362–73.

    Article  CAS  Google Scholar 

  7. James AW, Rabl C, Westphalen AC, Fogarty PF, Posselt AM, Campos GM. Portomesenteric venous thrombosis after laparoscopic surgery: a systematic literature review. Arch Surg. 2009;144:520–6.

    Article  Google Scholar 

  8. Salinas J, Barros D, Salgado N, et al. Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy. Surg Endosc. 2014;28:1083–9.

    Article  Google Scholar 

  9. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51:70–8.

    Article  Google Scholar 

  10. Shoar S, Saber AA, Rubenstein R, et al. Portomesentric and splenic vein thrombosis (PMSVT) after bariatric surgery: a systematic review of 110 patients. Surg Obes Relat Dis. 2018;14:47–59.

    Article  Google Scholar 

  11. Rottenstreich A, Elazary R, Kalish Y. Abdominal thrombotic complications following bariatric surgery. Surg Obes Relat Dis. 2017;13:78–84.

    Article  Google Scholar 

  12. Goitein D, Matter I, Raziel A, et al. Portomesenteric thrombosis following laparoscopic bariatric surgery: incidence, patterns of clinical presentation, and etiology in a bariatric patient population. JAMA Surg. 2013;148:340–6.

    Article  Google Scholar 

  13. Moon RC, Ghanem M, Teixeira AF, et al. Assessing risk factors, presentation, and management of portomesenteric vein thrombosis after sleeve gastrectomy: a multicenter case-control study. Surg Obes Relat Dis. 2018;14:478–83.

    Article  Google Scholar 

  14. Lim W, Le Gal G, Bates SM, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism. Blood Adv. 2018;2:3226–56.

    Google Scholar 

  15. Bradbury MS, Kavanagh PV, Chen MY, Weber TM, Bechtold RE. Noninvasive assessment of portomesenteric venous thrombosis: current concepts and imaging strategies. J Comput Assist Tomogr. 2002;26:392–404.

    Article  Google Scholar 

  16. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet. 1960;1:1309–12.

    Article  CAS  Google Scholar 

  17. Prins MH, Hutten BA, Koopman MM, Buller HR. Long-term treatment of venous thromboembolic disease. Thromb Haemost. 1999;82:892–8.

    Article  CAS  Google Scholar 

  18. Olaf M, Cooney R. Deep venous thrombosis. Emerg Med Clin North Am. 2017;35:743–70.

    Article  Google Scholar 

  19. Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. 2004;126:338S–400S.

    Article  CAS  Google Scholar 

  20. Haskins IN, Rivas L, Ju T, et al. The association of IVC filter placement with the incidence of postoperative pulmonary embolism following laparoscopic bariatric surgery: an analysis of the metabolic and bariatric surgery accreditation and quality improvement project. Surg Obes Relat Dis. 2019;15(1):109–15.

    Article  Google Scholar 

  21. Zhang JY, Wang YB, Gong JP, Zhang F, Zhao Y. Postoperative anticoagulants in preventing portal vein thrombosis in patients undergoing splenectomy because of liver cirrhosis: a meta-analysis. Am Surg. 2016;82:1169–77.

    PubMed  Google Scholar 

  22. Caruso F, Cesana G, Lomaglio L, et al. Is Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy related to short-course prophylaxis of thromboembolism? A monocentric retrospective analysis about an infrequent but not rare complication and review of the literature. J Laparoendosc Adv Surg Tech A. 2017;27:987–96.

    Article  Google Scholar 

  23. Brocks DR, Ben-Eltriki M, Gabr RQ, Padwal RS. The effects of gastric bypass surgery on drug absorption and pharmacokinetics. Expert Opin Drug Metab Toxicol. 2012;8:1505–19.

    Article  CAS  Google Scholar 

  24. Martin KA, Lee CR, Farrell TM, Moll S. Oral anticoagulant use after bariatric surgery: a literature review and clinical guidance. Am J Med. 2017;130:517–24.

    Article  CAS  Google Scholar 

  25. Kubitza D, Becka M, Voith B, Zuehlsdorf M, Wensing G. Safety, pharmacodynamics, and pharmacokinetics of single doses of BAY 59-7939, an oral, direct factor Xa inhibitor. Clin Pharmacol Ther. 2005;78:412–21.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alex Escalona .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Muñoz, F., Escalona, A. (2020). Thrombo-Prophylaxis and Avoidance of Portal Vein Thrombosis. In: Gagner, M., Cardoso, A., Palermo, M., Noel, P., Nocca, D. (eds) The Perfect Sleeve Gastrectomy. Springer, Cham. https://doi.org/10.1007/978-3-030-28936-2_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-28936-2_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28935-5

  • Online ISBN: 978-3-030-28936-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics