Portomesenteric vein thrombosis in sleeve gastrectomy: a 10-year review

Tan, Stéphanie; Greenslade, Justin; Martín, David; Talbot, Michael; Loi, Ken; Hopkins, George

doi:10.1016/j.soard.2017.12.010

Cited by 41 publications

(41 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the last 10 years, PMVT is seen more often in the postoperative period due to higher numbers of bariatric surgery being performed (13). The incidence of PMVT after bariatric surgery is between 0.3-1% and when compared to other bariatric techniques it is more commonly seen after LSG (13,19). In our study, the incidence of PMVT is 0.58% and is consistent with the literature.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Laparoskopik Sleeve Gastrektomi Sonrası Portomezenterik Venöz Tromboembolinin Non-Operatif Yönetimi ve Uzun Dönem Anti Koagülan Proflaksinin Önemi

Uludağ¹

2021

Turkish Journal of Diabetes and Obesity

View full text Add to dashboard Cite

Aim: Portomesenteric venous thrombosis (PMVT) is a rare and life-threatening complication of laparoscopic sleeve gastrectomy (LSG). Treatment is usually established with proper anticoagulant prophylaxis. In this study, we aimed to focus on the incidence, clinical characteristics, follow-up, and treatment of patients who have undergone LSG procedures and developed PMVT. Material and Methods: Between the years of 2010 -2019, we retrospectively screened 683 patients who had undergone LSG operation due to obesity. In all patients, the diagnosis was established with abdominal computerized tomography (CT). Age, gender, body mass index (BMI), thrombosis risk factors, surgical details, PMVT clinical characteristics, follow-up, and treatment features were analyzed in patients diagnosed with PMVT. Results: LSG was performed on 683 patients and four patients (0.58%) developed PMVT. The average age of patients was 36.25±6.89 (29-45) years and only three patients were female. The average BMI was 36.42±0.95 (35.1-37.3) kg/m 2 . Three patients had a smoking history. All patients received anticoagulant therapy and responded to conservative treatment. The average length of stay in the hospital was 2.75±0.5 days (2-3). The average length of stay on the second admission to the hospital was 8.75 days (5-8 days). One patient had the diagnosis of protein C deficiency. No mortality or morbidity was observed. Conclusion:PMVT is a rare but serious complication following bariatric surgery. Conservative treatment is fundamental. Treatment is required based on any underlying disease if present. Surgical intervention is required for small bowel necrosis. The findings of our study support the information that long-term anticoagulant prophylaxis plays a role in preventing PMVT after LSG, as well as improving prognosis on patients who have already developed PMVT. To evaluate the long-term effects of PMVT on patients, a longer time of follow-up and a larger patient population is needed.

show abstract

Section: Discussionsupporting

confidence: 90%

“…Nowadays, conservative treatment includes anticoagulant or antithrombotic therapy (8,18). Systemic anticoagulant therapy should be continued for at least 3-6 months after discharge (13,19,20). If there is any underlying thrombophilic disease, anticoagulant therapy is advised to be used lifelong (9,13,21).…”

Section: Discussionmentioning

confidence: 99%

Laparoskopik Sleeve Gastrektomi Sonrası Portomezenterik Venöz Tromboembolinin Non-Operatif Yönetimi ve Uzun Dönem Anti Koagülan Proflaksinin Önemi

Uludağ¹

2021

Turkish Journal of Diabetes and Obesity

View full text Add to dashboard Cite

show abstract

“…These in contrast to another study (10), which suggested a failure rate of exceeding 65% (10) with heparin anticoagulation alone. Therefore, for a symptomatic patient with occlusive, partial to complete thrombosis bowel more rapid recanalization by adopting a combined therapy of systemic IV anticoagulation and CDT is needed (7,10). This was evidenced in 75 to 100% of PMVT patients with at partial venous recanalization was observed in patients receiving the combined with overall excellent success rates (11,12).…”

Section: Discussionmentioning

confidence: 99%

Catheter-Directed Thrombolysis in the Treatment of Acute Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy

Barah¹,

Al-Hashimi²,

Kassamali³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Portomesenteric vein thrombosis (PMVT) following Laparoscopic Sleeve Gastrectomy (LSG) is an uncommon but potentially debilitating complication. Catheter-directed thrombolysis (CDT) has an evolving role in recanalizing the venous flow and preventing thrombus propagation. It can be used as an alternative or in combination with systemic anticoagulants in selected patients. We report two cases of trans-hepatic and trans-splenic CDT of acute PMVT developed in post LSG. The patient's clinical details, radiological findings, safety, and efficacy are reported.Cases presentation: Two patients presented to the emergency department (ED) within 14 days of surgery. The presenting complaints were generally nonspecific. The diagnosis of PMVT was established in both patients based on abdominal contrast-enhanced computed tomography (CECT). The two patients received a combined therapy of intravenous (IV) heparinization and CDT using trans-hepatic approach in case 1 and trans-splenic approach in case 2, determined by the extent of thrombosis. Subsequent post-procedure venograms and CECT were performed and showed significant thrombus resolution. Both patients received long-term anticoagulant therapy upon discharge with a successful overall recovery. Conclusion: PMVT is an infrequent and severe post LSG complication. Various approaches for re-establishing the portal venous flow have been described according to the severity of venous thrombosis. This article describes CDT therapy as a safe and effective option for treating PMVT in symptomatic patients.

show abstract

“…There are no established guidelines for the duration of anticoagulation therapy, but patients are usually treated for 3-6 months. Surgical treatment is reserved for patients with evidence of infarcted bowel [84].…”

Section: Portomesenteric Venous Thrombosismentioning

confidence: 99%

Laparoscopic Sleeve Gastrectomy: Outcomes, Safety and Complications

Ansari¹

2021

Bariatric Surgery - From the Non-Surgical Approach to the Post-Surgery Individual Care

View full text Add to dashboard Cite

Worldwide, the numbers of laparoscopic sleeve gastrectomy (LSG) performed grown exponentially over the last decade, because of its simplicity, safety profile and excellent outcomes in terms of durable weight loss and improvement of obesity-associated comorbidities. This chapter will provide a comprehensive review on the outcomes of LSG as a metabolic surgery. It appraises LSG\'s short, mid and long term weight loss outcomes, and compares these outcomes with those of other types of bariatric surgery. Then, a wider range of LSG outcomes are discussed, including a variety of comorbidities, clinical, biochemical and inflammatory parameters, while appraising the positive metabolic effects of LSG. The chapter also outlines the issues pertaining to LSG among a range of special populations such as adolescents, the elderly, renal transplant patients and others. The chapter concludes with a review of the safety and most common complications that may be encountered in the short term and long term, including surgical and nutritional complications, as well as mortality.

show abstract

Portomesenteric vein thrombosis in sleeve gastrectomy: a 10-year review

Cited by 41 publications

References 32 publications

Laparoskopik Sleeve Gastrektomi Sonrası Portomezenterik Venöz Tromboembolinin Non-Operatif Yönetimi ve Uzun Dönem Anti Koagülan Proflaksinin Önemi

Laparoskopik Sleeve Gastrektomi Sonrası Portomezenterik Venöz Tromboembolinin Non-Operatif Yönetimi ve Uzun Dönem Anti Koagülan Proflaksinin Önemi

Catheter-Directed Thrombolysis in the Treatment of Acute Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy

Laparoscopic Sleeve Gastrectomy: Outcomes, Safety and Complications

Contact Info

Product

Resources

About