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Prevalence of Pulmonary Embolism After Bariatric Surgery: a Systematic Review and Meta-Analysis
Davoud Khalilzadeh Bonab1, Masoud Dehbozorgi2, Arman Shafiee3
1Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
Background:
Pulmonary embolism (PE) is a potentially life-threatening complication following bariatric surgery. Accurate estimates of its prevalence are essential to inform perioperative risk management and thromboprophylaxis strategies.
Methods:
This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Observational studies and randomized controlled trials reporting postoperative PE among adults (≥ 18 years) undergoing bariatric procedures-including sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding-were included.
Results:
Nine studies comprising 1,080,346 patients were included. The pooled prevalence of PE following metabolic-bariatric surgery (MBS) was 3.70 per 1000 procedures (95% CI: 1.71-6.30), with substantial heterogeneity (I² = 99.48%). Subgroup analysis revealed the highest prevalence in open bariatric surgery (7.58 per 1000; 95% CI: 4.10-11.99), intermediate in procedures with unreported surgical approach (2.97 per 1000; 95% CI: 0.76-6.62), and lowest in laparoscopic procedures (1.90 per 1000; 95% CI: 0.00-5.95). Prevalence estimates were similar between prospective and retrospective studies.
Conclusion:
PE is an uncommon but clinically significant complication after MBS, with risk strongly influenced by surgical technique. These findings emphasize the importance of vigilant perioperative monitoring and tailored thromboprophylaxis, particularly in open procedures.
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