Incidence of deep vein thrombosis and thrombosis of the portal-mesenteric axis after laparoscopic sleeve gastrectomy

J Laparoendosc Adv Surg Tech A. 2014 Sep;24(9):601-5. doi: 10.1089/lap.2014.0125. Epub 2014 Jul 29.

Abstract

Background: Venous thromboembolism is the most common postoperative medical complication after bariatric surgery. Mortality associated with thromboembolic processes can reach up to 50%-75%. The aim of this study was to determine the incidence of deep vein thrombosis (DVT) and portal-splenic-mesenteric vein thrombosis (PSMVT) in our population undergoing laparoscopic sleeve gastrectomy (LSG) as the bariatric technique, with an anti-thromboembolic dosage scheme of 0.5 mg/kg/day 12 hours preoperatively and maintained during 30 days postoperatively.

Patients and methods: A prospective observational study was performed, including 100 consecutive patients undergoing LSG between October 2007 and September 2013. To determine the incidence of DVT and PSMVT, all patients undergo contrast-enhanced abdominal computed tomography (CT) and Doppler ultrasonography (US) of both lower limbs on the third postoperative month, whether they were asymptomatic or symptomatic.

Results: Contrast-enhanced CT showed 1 case of PSMVT (1%). Two patients presented DVT in the right leg (2%). All the cases were asymptomatic.

Conclusions: The incidence of PSMVT and DVT after LSG with a prophylactic low-molecular-weight heparin dose of 0.5 mg/kg/day and maintained during 30 days postoperatively is 1% and 2%, respectively. According to these results, a postoperative screening with Doppler US and/or contrast-enhanced CT seems to be unnecessary.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Asymptomatic Diseases / epidemiology
  • Bariatric Surgery / methods
  • Chemoprevention
  • Female
  • Gastrectomy / methods*
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Incidence
  • Lower Extremity / diagnostic imaging
  • Male
  • Mesenteric Ischemia / diagnostic imaging
  • Mesenteric Ischemia / epidemiology*
  • Mesenteric Ischemia / prevention & control
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Portal Vein / diagnostic imaging*
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Splenic Vein / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / epidemiology*
  • Venous Thrombosis / prevention & control

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight