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Surgical Endoscopy

, Volume 29, Issue 4, pp 882–889 | Cite as

The efficacy of prophylactic IVC filters in gastric bypass surgery

  • B. Jakub WilhelmEmail author
  • Alexey Markelov
  • Aniket K. Sakharpe
  • Leopoldo M. Baccaro
  • Vinay Singhal
Article

Abstract

Background

Patients undergoing gastric bypass surgery have a high risk for thromboembolic events. Over the last decade, the use of prophylactic IVC filters (IVCF) has drastically increased for patients who are considered high risk. However, the role and efficacy of prophylactic IVCF placement remain controversial, and the literature is limited to a few retrospective studies.

Methods

We conducted a systematic review of the literature. A total of 21 articles were analyzed, and eight relevant retrospective studies were chosen for review of data. Data from laparoscopic gastric bypass surgery were compared to open gastric bypass surgery

Results

The relevant eight retrospective studies included a total of 597 patients. Patients had IVCFs before laparoscopic gastric bypass (41 %) and before open gastric bypass (59 %). There were 5 postoperative pulmonary emboli (PE) (0.84 %), 21 DVTs (3.52 %), 5 minor IVCF-related complications (0.84 %), 2 major IVCF-related complications (0.34 %), and 10 deaths (1.68 %). The rate of postoperative PE was the same in the laparoscopic group and the open group (0.84 %). The rate of DVT in the laparoscopic group was 5.02 %, and in the open group, it was 2.23 %.

Conclusion

It is estimated that 55 % of bariatric surgeons use IVCF in high-risk patients. Prospective research that supports the use of IVCF is very limited, and individualized placement relies on retrospective studies only. In addition, patient characteristics associated with high risk vary between different studies. Our review showed that most of the published studies support the use of prophylactic IVCF and found it to be safe. On the other hand, the largest and most recent retrospective cohort study does not support their use. The efficacy of prophylactic IVCFs before gastric bypass surgery in high-risk patients has not been established.

Keywords

Bariatric Obesity Pneumoperitoneum Complications Vascular 

Notes

Acknowledgments

We wish to thank our research coordinator Dr. David Livert, PhD for his assistance in editing and critically reviewing this article.

Disclosures

Drs. B. Jakub Wilhelm, Alexey Markelov, Leopoldo M. Baccaro, Aniket K. Sakharpe, Vinay Singhal have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • B. Jakub Wilhelm
    • 1
    Email author
  • Alexey Markelov
    • 2
  • Aniket K. Sakharpe
    • 1
  • Leopoldo M. Baccaro
    • 1
  • Vinay Singhal
    • 1
    • 3
  1. 1.Department of Surgery, Easton HospitalDrexel University College of MedicineEastonUSA
  2. 2.Department of Plastic and Reconstructive SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Department of Minimally Invasive SurgeryHershey Medical CenterHersheyUSA

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