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Portomesenteric Vein Thrombosis after Bariatric Surgery: An Online Survey

Francesco Maria Carrano1,2, Sylvia Weiner3, Moustafa Elshafei3

  • 1PhD Program in Applied Medical-Surgical Sciences, University of Rome "Tor Vergata", 00133 Rome, Italy.

Journal of Clinical Medicine
|September 10, 2021
PubMed

Insights

Portomesenteric vein thrombosis (PMVT) is a rare complication after bariatric surgery, most often linked to sleeve gastrectomy. This largest-to-date survey highlights a significant lack of standardized prevention and treatment protocols for PMVT.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Bariatric Surgery

Background:

  • Portomesenteric vein thrombosis (PMVT) is a rare but serious complication following bariatric surgery, with an incidence ranging from 0.3% to 1%.
  • Existing literature on PMVT post-bariatric procedures is limited, leading to a lack of standardized management guidelines.

Purpose of the Study:

  • To investigate the occurrence and characteristics of PMVT in patients who have undergone bariatric surgery.
  • To identify surgical procedures most frequently associated with PMVT.
  • To assess current practices in prophylaxis and treatment of PMVT.

Main Methods:

  • A 27-item online questionnaire was distributed to members of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).
  • The survey collected data on reported PMVT cases, associated surgical procedures, clinical presentation, and management strategies.
  • Data were analyzed from 89 bariatric surgeons across 61 countries.

Main Results:

  • Twenty-six surgeons (29.21%) reported at least one PMVT case, with sleeve gastrectomy being the most frequently associated procedure (84.6%).
  • Abdominal pain was the predominant symptom (96.15%), occurring approximately 19 days post-surgery.
  • Significant variability in prophylaxis and treatment modalities was observed, indicating a lack of standardized care.

Conclusions:

  • Sleeve gastrectomy is strongly associated with PMVT, necessitating further research into preventative strategies.
  • The study underscores a critical gap in standardized protocols for PMVT prophylaxis and treatment in the post-bariatric surgery population.
  • Further investigation and consensus development are required to optimize patient outcomes and reduce PMVT incidence.
Keywords:
RYGBbariatric surgeryportal vein thrombosisportomesenteric vein thrombosissleeve gastrectomy

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