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The Safety of Laparoscopic Sleeve Gastrectomy in Patients Receiving Chronic Anticoagulation Therapy: A Case-Matched Study

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Abstract

Background

Obesity is linked to cardiac disorders with a relative risk of atrial fibrillation of 1.5 (requiring the use of chronic anticoagulation therapy, CAT). However, CAT is a known risk factor for postoperative bleeding after elective surgery. The primary objective of the present study was to evaluate the short- and long-term complications of laparoscopic sleeve gastrectomy (LSG) in patients receiving CAT.

Methods

This is a retrospective analysis of a prospective database of CAT patients undergoing LSG between March 2004 and December 2012. This LSG-CAT group was matched 1:2 on preoperative data with patients not receiving CAT (LSG-control group). Primary efficacy criterion was the frequency of CAT-related complications. Secondary efficacy criteria were the major postoperative complications, frequency of revisional surgery, long-term CAT-related complications, and a change in the dose level of oral anticoagulants.

Results

The LSG-CAT group consisted of 15 patients with a median age of 54 years (32–65). The LSG-control group consisted of 30 patients. Median operating time was 75 min in both groups (p = 0.33). Major complication rates in the LSG-CAT and LSG-control groups were 13.3 and 3.3 %, respectively (p = 0.20), with one case of postoperative bleeding in each group (6.7 and 3.3 %, p = 0.6); incidence of revisional surgery was 13.3 and 3.3 % (p = 0.2). There were no postoperative mortalities. After a median follow-up of 14 months (9–43), no changes in the dose level of oral anticoagulants were reported.

Conclusions

LSG in patients receiving CAT is not associated with CAT-specific complications. This surgical procedure enables good weight loss and does not require change in the dose level of oral anticoagulants.

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Abbreviations

LSG:

Laparoscopic sleeve gastrectomy

EWL:

Excessive weight loss

BMI:

Body mass index

RYGBP:

Roux-en-Y gastric bypass

LMWH:

Low molecular weight heparin

CAT:

Chronic anticoagulation therapy

INR:

International normalized ratio

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Conflict of interest

None of the authors have any conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Digestive Surgery, Amiens University Hospital and Jules Verne University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France

    Olivier Gerin, Lionel Rebibo, Abdennaceur Dhahri & Jean-Marc Regimbeau

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  1. Olivier Gerin
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  2. Lionel Rebibo
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  3. Abdennaceur Dhahri
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  4. Jean-Marc Regimbeau
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Correspondence to Jean-Marc Regimbeau.

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Gerin, O., Rebibo, L., Dhahri, A. et al. The Safety of Laparoscopic Sleeve Gastrectomy in Patients Receiving Chronic Anticoagulation Therapy: A Case-Matched Study. OBES SURG 25, 1686–1692 (2015). https://doi.org/10.1007/s11695-015-1590-1

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