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.
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References
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.
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.
Stieber AC, Zetti G, Todo S, et al. The spectrum of portal vein thrombosis in liver transplantation. Ann Surg. 1991;213:199–206.
Swartz DE, Felix EL. Acute mesenteric venous thrombosis following laparoscopic Roux-en-Y gastric bypass. JSLS. 2004;8:165–9.
Bellanger DE, Hargroder AG, Greenway FL. Mesenteric venous thrombosis after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2010;6:109–11.
Hassn AM, Al-Fallouji MA, Ouf TI, Saad R. Portal vein thrombosis following splenectomy. Br J Surg. 2000;87:362–73.
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.
Salinas J, Barros D, Salgado N, et al. Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy. Surg Endosc. 2014;28:1083–9.
Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51:70–8.
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.
Rottenstreich A, Elazary R, Kalish Y. Abdominal thrombotic complications following bariatric surgery. Surg Obes Relat Dis. 2017;13:78–84.
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.
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.
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.
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.
Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet. 1960;1:1309–12.
Prins MH, Hutten BA, Koopman MM, Buller HR. Long-term treatment of venous thromboembolic disease. Thromb Haemost. 1999;82:892–8.
Olaf M, Cooney R. Deep venous thrombosis. Emerg Med Clin North Am. 2017;35:743–70.
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.
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.
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.
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.
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.
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.
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.
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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
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DOI: https://doi.org/10.1007/978-3-030-28936-2_5
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