Portomesenteric vein thrombosis in patients undergoing sleeve gastrectomy: An updated meta-analysis of 101,865 patients

Dimitrios Giannis, Georgios Geropoulos, Christos D Kakos, Weiying Lu, Salim El Hadwe, Massimiliano Fornasiero, Andrew Robertson, Chetan Parmar

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Portomesenteric vein thrombosis (PMVT) is a rare but potentially fatal complication of sleeve gastrectomy (SG). The rising prevalence of SG has led to a surge in the occurrence of PMVT, while the associated risk factors have not been fully elucidated.
Objectives: This study aims to determine the incidence and risk factors of PMVT in patients undergoing SG.
Methods: A comprehensive literature search was performed in PubMed (MEDLINE) and EMBASE databases. Proportion and regression meta-analyses were conducted.
Results: A total of 75 studies and 101,865 patients undergoing SG and 355 patients with PMVT were identified. At a mean follow-up of 14.4 (SD: 16.3) months the incidence of PMVT was found to be 0.48% (95%CI: 0.39-0.60%). The majority of the population presented with abdominal pain (91.8%) at an average of 22.4 days postoperatively and PMV was mainly diagnosed with CT scan (96.0%). Hematologic abnormalities predisposing to thrombophilia were identified in 34.9% of the population. Age (p=0.02) and center volume (p <0.0001) were significantly associated with PMVT, while gender, BMI, hematologic abnormality, prior history of deep vein thrombosis or pulmonary embolism, type of prophylactic anticoagulation, and duration of prophylactic anticoagulation were not associated with the incidence of PMVT in meta-regression analyses. Treatment included therapeutic anticoagulation in 93.4% and the mortality rate was 4/355 (1.1%).
Conclusion: PMVT is a rare complication of sleeve gastrectomy with an incidence rate <1% that is associated with center volume and age but is not affected by the duration or type of thromboprophylaxis administered postoperatively.

Original languageEnglish
JournalObesity surgery
Publication statusPublished - 23 Jul 2023


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