Is Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy Related to Short-Course Prophylaxis of Thromboembolism? A Monocentric Retrospective Analysis About an Infrequent but Not Rare Complication and Review of the Literature

Abstract

PMVT is an infrequent but not rare complication in patients who undergo LSG. Short-course antithrombotic prophylaxis (<10 days) could increase the risk of this complication. The authors recommend a postoperative prophylaxis with sodium enoxaparin 40 mg sc once a day for 4 weeks. PMVT mortality in patients who undergo LSG is lower than other causes of portal vein thrombosis (hepatic cirrhosis, tumors, myeloproliferative disorders, etc.) If risk factors for PMVT are present preoperatively, the authors recommend a prophylaxis with sodium enoxaparin 40 mg sc twice daily for 4 weeks.

Missing something? A scoping review of venous thromboembolic events and their associations with bariatric surgery. Refining the evidence base

“…In 2014, SG was the most performed BS, comprising >50% of all primary BS in 2016, and had the highest increase rates in recent years [ 36 , 77 , 78 ]. Post-SG PMVT incidence is 0.37%–1% and is increasing with SG's popularity [ 79 ]; and a 0.1%–1.81% PMVT incidence has been observed post-BS including laparoscopic BS [ [80] , [81] , [82] ]. Research has reported a 1.61% PMVT mortality rate [ 82 ].…”

“…Post-SG PMVT incidence is 0.37%–1% and is increasing with SG's popularity [ 79 ]; and a 0.1%–1.81% PMVT incidence has been observed post-BS including laparoscopic BS [ [80] , [81] , [82] ]. Research has reported a 1.61% PMVT mortality rate [ 82 ]. It is unclear if this increased incidence is due to the increasing frequency of LSG, or if LSG carries independent PVT risk [ 83 ].…”

“…PE after BS has high mortality [ 92 ], particularly post-discharge mortality [ 93 , 96 ]. Autopsy found PE as leading cause of death in 20.7% of deceased patients after BS [ 97 ]; and PMVT has 1.61% mortality [ 82 ].…”

Portomesenteric Vein Thrombosis after Laparoscopic Sleeve Gastrectomy

“…PMVT in LSG was first reported in 2009 by Berthet et al [7]. Caruso et al [8] reported only one PMVT case in their 2854 patients whose underwent LSG for morbid obesity. They also revealed 62 cases of PMVT after LSG with a prevalence of 0.52% (ranging from 0.2 to 1.81%) and a mortality rate of 1.61% in selected 18 studies [8].…”

“…Caruso et al [8] reported only one PMVT case in their 2854 patients whose underwent LSG for morbid obesity. They also revealed 62 cases of PMVT after LSG with a prevalence of 0.52% (ranging from 0.2 to 1.81%) and a mortality rate of 1.61% in selected 18 studies [8]. The incidence of PMVT is 0.19% in all obesity surgery and 0.28% in LSG in our institution without any mortality.…”