Early Effects of Laparoscopic Sleeve Gastrectomy and Laparoscopic One-Anastomosis Gastric Bypass on Portal Venous Flow: a Prospective Cohort Study

Osman, Ayman M. A.; Salah, Ayman; Mikhail, Sameh; AlAyat, Ayman A.; Serour, Dalia K.; Ibrahim, Mohamed

doi:10.1007/s11695-021-05267-3

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…Although the reduction of portal venous flow is a known factor for the occurrence of PMVT [17], it is yet to be clarified if transitory flow reduction during surgery can be sufficient to initiate PMVT. A recent study by Osman et al associated LSG with greater reduction in portal venous peak systolic flow velocity in the early postoperative period, compared to other bariatric procedures, although no PMVT occurred in the study cohort [18]. Induction of a pneumoperitoneum with an intra-abdominal pressure of more than 14 mmHg has been demonstrated to reduce portal venous blood flow by 50%, that is further reduced by the prolonged reverse-Trendelenburg position.…”

Section: Discussionmentioning

confidence: 90%

Portomesenteric Vein Thrombosis after Bariatric Surgery: An Online Survey

Carrano

Weiner

Elshafei

et al. 2021

JCM

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Portomesenteric vein thrombosis (PMVT) is a rare post-operative complication of bariatric procedures, occurring in between 0.3% and 1% of cases. A structured questionnaire consisting of 27 items was available online to members of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) to investigate the occurrence of PMVT. A total of 89 bariatric surgeons from 61 countries participated. Twenty-six (29.21%) reported at least one case of PMVT (46.15% males; 53.84% females). The surgery most associated with PMVT occurrence was sleeve gastrectomy (84.6%), followed by Roux-en-Y gastric bypass (RYGB) (7.69%), and laparoscopic adjustable gastric banding (LAGB) (7.69%). The time gap between surgery and PMVT was 19.28 ± 8.72 days. The predominant symptom was abdominal pain in 96.15% of patients, followed by fever in 26.9%. Complete occlusion of the portal vein was reported in 34.6% of cases, with involvement of the portal system in 69%, extension to the superior mesenteric district in 23%, and extension to the splenic vein in two patients (7.7%). Our survey, which is the largest regarding PMVT to date, revealed a diffuse lack of standardization in the choice, duration, and dosing of prophylaxis regimens as well as treatment modalities, reflecting the literature gap on the topic.

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Section: Discussionmentioning

confidence: 90%

Portomesenteric Vein Thrombosis after Bariatric Surgery: An Online Survey

Carrano

Weiner

Elshafei

et al. 2021

JCM

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“…However, the statistical analysis showed a higher risk of DVT after SG surgery in the summer closure group, which may indicate that SG is not completely insensitive to longer intervals of performed surgeries. While the relation to summer closure remains unclear, SG has been reported to induce a hypercoagulable state [ 27 ] as well as a reduced blood flow velocity [ 28 ] which may in part explain why an increased risk for this particular complication was seen after SG but not after RYGB, despite the higher overall complication rates after RYGB.…”

Section: Discussionmentioning

confidence: 99%

The influence of summer closure on serious postoperative complications in bariatric surgery

Fall

Sundbom

Stenberg

2022

Langenbecks Arch Surg

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Introduction Bariatric surgery is an effective method of treating obesity, with gastric bypass and sleeve gastrectomy being the most common techniques used worldwide. Despite the technical challenges in these methods, little is known about the effects of summer closure on the incidence of serious postoperative complications in surgeries performed shortly after summer vacation. This has therefore been studied in our large cohort. Materials and methods A retrospective cohort study based on data from the Scandinavian Obesity Surgery Registry was conducted. Patients who underwent a primary gastric bypass or sleeve gastrectomy operation between 2010 and 2019 were included. The rate of serious complications within 30 days after surgery for patients who underwent surgery the first month after summer closure was compared to those who underwent surgery during the rest of the year using the χ2 test and adjusted logistic regression. Results The study included 42,404 patients, 36,094 of whom underwent gastric bypass and 6310 of whom received sleeve gastrectomy. Summer closure was associated with an increased risk for serious postoperative complications in gastric bypass surgery (adjusted odds ratio (adj-OR) = 1.17; 95% confidence interval (CI): 1.01–1.36). No statistically significant association was seen for sleeve gastrectomy (adj-OR = 1.17; 95% CI: 0.72–1.91), nor in overall complication rate. Conclusions Summer closure increases the risk of serious postoperative complications in gastric bypass surgery. No statistically significant association was found for sleeve gastrectomy surgery.

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