Portal Vein Thrombosis Due to Factor 2 Leiden in the Post-operative Course of a Laparoscopic Sleeve Gastrectomy for Morbid Obesity

Abstract

Portal vein thrombosis can occur after laparoscopic operations. This complication has not been yet reported after laparoscopic sleeve gastrectomy. We report the case of a patient who presented mild abdominal pains 2 weeks after a laparoscopic sleeve gastrectomy achieved to cure morbid obesity. Computed tomography led to the diagnosis of portal vein thrombosis bound to a genetic disorder due to heterozygote Leiden 2 factor which impaired coagulation. Recommendations for post-surgical follow-up are discussed.

Portal Vein Thrombosis Following Laparoscopic Sleeve Gastrectomy for Morbid Obesity

“…Included among the laparoscopic procedures with reported postoperative PVT are resections of the appendix, gallbladder, and colon, as well as Nissen fundoplication for gastroesophageal reflux disease, and bariatric surgery for morbid obesity. 3–8 Although the cause of PVT after laparoscopy is unknown, it is established that increased intraabdominal pressure with pneumoperitoneum results in decreased portal venous blood flow, which may lead to a relative prothrombotic environment. 9,10 …”

Portal vein thrombosis after laparoscopic sleeve gastrectomy: presentation and management

“…The incidence of PVT in our series is o1%, with a range of .3%-1% reported in literature [1,[6][7][8][9][10]. A precise explanation for this increased risk is unclear.…”

“…The reported incidence is 3% [1]. Portal vein thrombosis (PVT) occurs less frequently, but has been reported after laparoscopic adjustable gastric band (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic sleeve gastrectomy (LSG) [2][3][4][5][6][7][8][9][10]. There appears to be an unexplained statistical increase of PVT after LSG compared with other/abdominal procedures.…”

“…There appears to be an unexplained statistical increase of PVT after LSG compared with other/abdominal procedures. Surprisingly, there is a higher rate of PVT after LSG even compared with patients after the duodenal switch procedure (DS) [1,[6][7][8][9][10]. Most centers use only heparin anticoagulation to treat PVT; however, heparin alone has a significant failure rate, approaching 65% in the best available study [11].…”

Calidad de vida y tolerancia alimentaria pos operatoria en el paciente obeso tratado mediante gastrectomía tubular laparoscópica

“…Los abscesos de la cavidad abdominal representan otra posible complicación después de la gastrectomía tubular. Usualmente se presenta con síntomas tales como: [137][138] .…”