A retrospective comparative study of portomesenteric venous thrombosis after laparoscopic sleeve gastrectomy in morbidly obese patients with low BMI with and without anticoagulation

Fouda, Abdelrahman Y.; El Ashry, Alaa; AboElazm,, Hossam A.; Elbarbary, Mohab G.

doi:10.4103/ejs.ejs_156_22

A retrospective comparative study of portomesenteric venous thrombosis after laparoscopic sleeve gastrectomy in morbidly obese patients with low BMI with and without anticoagulation

Authors

Abstract

Background
Portomesenteric venous thrombosis (PMVT) is a life-threatening rare postoperative complication after laparoscopic sleeve gastrectomy (LSG). Thromboprophylaxis is essential to guard against venous thrombosis after laparoscopic surgery. This study points out the benefits of postoperative use of anticoagulation to prevent PMVT after LSG in morbidly obese patients with BMI of 35–45 kg/m.
Patients and methods
A retrospective comparative pilot study was conducted that included 60 patients with;Deg;BM;Deg;I between 35 and 45 kg/m who underwent LSG between January 2020 and January 2021 at El-Demerdash Hospital. Half of the patients received antithromboembolic dosage scheme of 0.5 mg/kg/day with the induction of anesthesia and for 14 days postoperatively (group A), whereas the other half had no postoperative anticoagulation prophylaxis (group B).
Results
Patients were followed up with lower limb venous duplex at 2-week, 3-, and 6-month interval from the operation or on appearance of symptoms of PMVT. No patient had PMVT in group A, whereas four patients had PMVT in group B confirmed by venous duplex.
Conclusion
The anticoagulated group showed better outcomes regarding the prevention of PMVT after surgery. Yet, the incidence of PMVT after LSG in patients with BMI of 35–45 kg/m was not affected only by anticoagulation. Evidence about PMVT prevention and thromboprophylaxis plan is still lacking, so we recommend further large prospective trials.

Keywords