• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

Portal-Mesenteric Thrombosis Following Laparoscopic Sleeve Gastrectomy A Rare but Potentially Serious Complication

Marcos Berry, MD, Patricio Lamoza, MD, Lionel Urrutia, MD, Alvaro Bustos, MD, Marco Schulz, MD, Eduardo Luna, MD, Macarena Haddad, MD. Clinica Las Condes.

Introduction:
Laparoscopic Sleeve Gastrectomy (LSG) has shown to be an effective surgical technique for obesity control and its associated co-morbidities, with comparable results to gastric bypass.
It has risks with associated morbidity and mortality from 0% to 1% according to different series.
Obese patients have a relative risk to develop venous thromboembolism (VTE) of 2.5 compared with non obese patients.
VTE represents the main cause of mortality in bariatric surgery. Porto-Mesenteric Thrombosis (PMT) in bariatric surgery has an incidence of 0.5 – 3% and a global mortality of 0.21%. Incidence of PMT in relation to LSG reaches up to 1%.
The objective of this study is to evaluate the incidence of PMT in a LSG series of patients and analyze their characteristics, risk factors, thrombosis extension and sequels.

Methods and Procedures:
Descriptive & retrospective study based on the analysis of a data base of consecutively LSG operated patients, by the same surgical team between April 2006 and August 2013.

Results:
Out of 1370 LSG, 4 patients developed PMT, Incidence 0.29%. Female / Male: 2 / 2, Mean Age 32 years old (22-38), Initial Weight 100.8 kg (87-126), Initial BMI 36 (32-42). Preop known risk factors: Contraceptive users 2, Smoke 3, DVT Family History 1, OR Time: 91 min (80 – 95), Conversions 0, DVT Prophylaxis all with enoxaparin 40 mg sc/day, Mean Hospital stay 3 days.
Symptoms:
Abdominal pain 4, nausea/vomits 1. Post op presentation day: 15 (10-59), Images: Abdominal-pelvic CT Scan / Angio CT. Re-admission mean hospital stay 7.5 days (6-30). CT findings: Portal vein (PV) exclusive 1, PV extended to Splenic Vein(SpV) 1, PV extended to SpV + SMV 1, other findings: Intestinal segmental ischemia 1.Treatment:
NPO, Anticoagulant (heparin and/or enoxaparin): Successful 3, Failed in 1 (PVT extended to SMV patient and intestinal ischemia & Intestinal necrosis), Surgery: small bowel resection.
Follow Up: 12 months (3-24), all asymptomatic, AngioCT complete permeabilization in 4. Thrombophilia Study: Positive 2, Factor V Deficit in 1, Factor VIII Excess in 1, Negative 2.

Conclusions:
Although PMT is a rare complication, it must be considered in the differential diagnosis of abdominal pain in the days or months following LSG. Prompt diagnosis is crucial to properly treat these patients and minimize morbidity. Thrombophilia is frequently identified as an underlying cause in our experience. LSG results are not affected in terms of weight loss in the midterm followup.

View Poster

Post Views: 58

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2014 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc