Portal vein thrombosis after Laparoscopic Bariatric Surgery it’s a rare complication but should be considered. Description of three cases with Literature Review.

Asem Ghasoup, MD, FACS1, Turki Al Qurashi, MD1, Mohammed Widinly, MD1, Omar Sadieh, MD, FACS2. 1Security Forces Hospital Makkah, 2Saad specialty Hospital

Background: Portal Vein Thrombosis (PVT) refers to an obstruction in the trunk of the portal vein it’s an uncommon complication after Laparoscopic Bariatric Surgery (LBS) However it is a potentially life-threatening condition reported after laparoscopic bariatric surgery. Clinical symptoms may be insidious, and progression can lead to intestinal infarction and portal hypertension.

Main Outcome Measures: Systematic review of the literature on PVT after LBS and report three cases encountered at our institution.

Patients and Methods: We reviewed the literature between January 1990, and January 2015, using the search terms portal vein thrombosis, mesenteric venous thrombosis, laparoscopic surgery and bariatric surgery.

The inclusion criteria were documented PVT by imaging studies such as angiography, ultrasonography, computed tomography [CT], or magnetic resonance imaging (MRI) or surgery following LBS.

We include three cases after laparoscopic sleeve gastrectomy from our institution.

Results: One developed a chronic cavernoma with extension of the thrombus to the superior mesenteric vein and splenic vein   , the other two cases recovered using anticoagulation therapy.

Conclusions: PVT is a rare complication after LBS, however Laparoscopic surgeons should be aware of the risk of PVT, and it should be suspected in cases with an atypical outcome after LBS. Once PVT is diagnosed, prompt anticoagulation therapy may resolve the thrombotic event.

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