A systematic review of portomesenteric vein thrombosis after sleeve gastrectomy.

BACKGROUND: Portomesenteric vein thrombosis (PMVT) is considered an uncommon complication in general surgery; nevertheless, with the growing popularity of sleeve gastrectomy (SG) as a bariatric procedure we have seen an increase in the occurrence of this complication.

OBJECTIVES: To elucidate the question if it is a procedure-related complication and explore the modalities of prevention and treatment of this complication, a systematic review of available literature regarding PMVT events after SG was conducted.

METHODS: Our systematic review yielded 28 studies enclosing 89 patients. Perioperative data was collected from each study and analyzed.

RESULTS: The incidence of PMVT after SG ranged from .37% to 1%, 65% of the patients were female, and the mean body mass index was 41.63 kg/m2 . Perioperative co-morbidities including hypertension, diabetes, and dyslipidemia were recorded in 39.7%, 41.63%, and 38.23% of cases respectively. Tachycardia and fever were reported only in 23.9% and 20.89%, respectively, and hereditary thrombophilia studies were positive in 30.43% of cases. The rate of acute major complications after PMVT was 14.6% (13 cases), and mortality was reported in 3 cases (average 3.37%).

CONCLUSION: PMVT seems to be an uncommon multifactorial disease, with unpredictable symptoms and varieties of the treatments options, but additional studies are required to further define optimal management and prevention algorithms.