title: Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy: Incidence, Analysis and Follow-Up in 1236 Consecutive Cases.
abstract: Portomesenteric vein thrombosis (PMVT) is a rare but severe complication after laparoscopic bariatric surgery, with potentially serious consequences. We aimed to describe the incidence, clinical features, management, outcome, and midterm follow-up in patients with PMVT after laparoscopic sleeve gastrectomy (LSG).
  
  
  
  This retrospective and descriptive study included patients who underwent LSG between November 2009 and July 2015 and developed PMVT. The following data were analyzed: age, gender, body mass index (BMI), thrombosis risk factors, surgical technique, thromboembolic prophylaxis, primary surgery outcomes, clinical features, treatment, thrombophilia testing results, and follow-up findings, including imaging and endoscopic findings.
  
  
  
  A total of 1236 patients underwent LSG, and 5 (0.4 %) developed PMVT. The mean age was 34.4 years, and 3 patients were women. The mean BMI was 38.5 kg/m2. Two patients had received hormonal contraceptive treatment. Four patients had a history of smoking. All of the patients received anticoagulant treatment, and none required surgery. The mean hospitalization duration was 7.6 days. Two patients showed complete recanalization. One patient showed portal cavernomatosis on delayed images. Two patients had a positive thrombophilia test. No portal hypertension endoscopic findings were observed.
  
  
  
  PMVT is a rare complication, for which smoking was identified as a predominant risk factor. Early diagnosis and prompt anticoagulant therapy could lead to a dramatic decrease in the incidence of intestinal infarction, mortality, and extrahepatic portal hypertension in the near future. However, careful follow-up is necessary to evaluate the impact of PMVT on long-term patient outcomes.
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile. villagranrodrigo@gmail.com.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Villagrán
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Smith
authors.affiliation: Department of Radiology, Bupa Antofagasta Clinic, Antofagasta, Chile.
authors.forename: Walter
authors.initials: W
authors.lastname: Rodriguez
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Flores
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile.
authors.forename: Mario
authors.initials: M
authors.lastname: Cariaga
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile.
authors.forename: Sofía
authors.initials: S
authors.lastname: Araya
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile.
authors.forename: Marisol
authors.initials: M
authors.lastname: Yañez
authors.affiliation: Bariatric Surgery Department, Bupa Antofagasta Clinic, Matta 1868, 2nd floor, Antofagasta, Chile.|Faculty of Medicine and Dentistry, Antofagasta University, Antofagasta, Chile.
authors.forename: Paulina
authors.initials: P
authors.lastname: Fuentes
authors.affiliation: Endocrinology Department, Bupa Antofagasta Clinic, Antofagasta, Chile.|Faculty of Medicine and Dentistry, Antofagasta University, Antofagasta, Chile.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Linares
authors.affiliation: Endocrinology Department, Bupa Antofagasta Clinic, Antofagasta, Chile.
authors.forename: Antonio
authors.initials: A
authors.lastname: Zapata
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D065666:Mesenteric Ischemia / Q000209:etiology / Q000628:therapy*; D009767:Obesity, Morbid / Q000601:surgery*; D011169:Portal Vein; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology* / Q000628:therapy
chemical_list: D000925:Anticoagulants
keywords: Bariatric complications; Bariatric thrombosis; Portal thrombosis; Sleeve gastrectomy; Splenic thrombosis; Thrombophilia