title: Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: a 36-case series.
abstract: Portomesenteric vein thrombosis following laparoscopic bariatric surgical procedures is a serious and potentially lethal complication. It is quite rare, and its clinical presentation, management, and sequelae remain poorly understood.
  
  
  
  We searched PubMed, Medline, Google Scholar, Ovid, and Cochrane databases for articles reporting case series and systematic reviews in the English language on patients who underwent laparoscopic bariatric surgery and had a subsequent portal or mesenteric vein thrombosis. Articles discussing laparoscopic gastric banding were excluded.
  
  
  
  A total of 14 articles reporting on 36 cases were found. We analyzed the pooled data from these case reports and series with emphasis on number of reported patients, demographics, time of diagnosis, risk factors, symptoms, management, complications, and sequelae.
  
  
  
  Portomesenteric vein thrombosis is not uncommon following laparoscopic bariatric surgery and appears to occur more after laparoscopic sleeve gastrectomy. Bariatric surgeons should have a high index of suspicion for early detection and treatment of this potentially lethal complication. Obese patients at high risk for venous thrombosis should be screened for genetic predisposition for hypercoagulable state and should be considered for extended thromboprophylaxis postoperatively.
authors.affiliation: Department of General and Thoracic Surgery, Virginia Mason Medical Center, 1100 Ninth Ave. C6-SUR, Seattle, WA, USA. moustapha_lakis@hotmail.com.
authors.forename: Mustapha A
authors.identifier: 0000-0002-8764-6917
authors.initials: MA
authors.lastname: El Lakis
authors.affiliation: Department of General Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Pozzi
authors.affiliation: Department of Surgery, Washington University in Saint Louis, Saint Louis, MO, USA.
authors.forename: Jad
authors.initials: J
authors.lastname: Chamieh
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Bassem
authors.initials: B
authors.lastname: Safadi
mesh_terms: D050110:Bariatric Surgery / Q000379:methods; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008403:Mass Screening; D008642:Mesenteric Veins; D009767:Obesity, Morbid / Q000601:surgery*; D011169:Portal Vein; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D019851:Thrombophilia / Q000175:diagnosis / Q000235:genetics; D020246:Venous Thrombosis / Q000453:epidemiology*
keywords: Bariatric surgery; Laparoscopy; Mesenteric vein thrombosis; Portal vein thrombosis