Portomesentric and splenic vein thrombosis (PMSVT) after bariatric surgery: a systematic review of 110 patients

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#adult #anticoagulants #bariatric-surgery #blood-coagulation-disorders #contraceptives-oral

Portomesentric and splenic vein thrombosis (PMSVT) after bariatric surgery: a systematic review of 110 patients

Shoar et al., 2018 | Surg Obes Relat Dis | Meta Analysis

Citation

Shoar Saeed, Saber Alan A, ... Aminian Ali. Portomesentric and splenic vein thrombosis (PMSVT) after bariatric surgery: a systematic review of 110 patients. Surg Obes Relat Dis. 2018-Jan;14(1):47-59. doi:10.1016/j.soard.2017.09.512

Abstract

BACKGROUND: Portomesenteric and splenic vein thrombosis (PMSVT) is a rare but potentially serious complication after bariatric surgery. No study has systematically analyzed its incidence and risk factors. OBJECTIVES: To pool the data regarding PMSVT after bariatric surgery and determine its incidence and risk factors. METHODS: A meta-analysis and systematic review was conducted to retrieve studies on PMSVT after bariatric surgery. RESULTS: A total of 41 eligible studies including 110 patients with postbariatric PMSVT were enrolled; the estimated incidence rate based on 13 studies was .4%. The use of oral contraception was reported in 35.4% of patients, previous surgery in 61.1%, smoking in 37.2%, and history of coagulopathy in 43%. PMSVT mostly occurred after sleeve gastrectomy (78.9%) and within the first postoperative month (88.9%). Pneumoperitoneum pressure was>15 mm Hg in 6% of patients. The portal vein was the most commonly affected vessel (41.5%). Prothrombin 20210 mutation and protein C/S deficiency were the most common thrombophilic conditions. Unfractionated heparin (59.1%), vitamin K antagonists (50.9%), and low molecular weight heparin (39.1%) were the most common treatments for PMSVT. The morbidity and mortality rates for postbariatric PMSVT were 8.2% and 3.6%, respectively. CONCLUSION: PMSVT usually occurs within the first postoperative month and is mostly reported after sleeve gastrectomy. The portal vein is the most commonly involved vessel. A previous hypercoagulable state can be an important risk factor. Most patients can be treated with anticoagulation therapy. Further studies with comprehensive data review of patient information are required.

Key Findings

A total of 41 eligible studies including 110 patients with postbariatric PMSVT were enrolled; the estimated incidence rate based on 13 studies was .4%. The use of oral contraception was reported in 35.4% of patients, previous surgery in 61.1%, smoking in 37.2%, and history of coagulopathy in 43%. PMSVT mostly occurred after sleeve gastrectomy (78.9%) and within the first postoperative month (88.9%). Pneumoperitoneum pressure was>15 mm Hg in 6% of patients. The portal vein was the most commonly a

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population postbariatric pmsvt were enrolled
Sample Size 110
Age Range See abstract
Condition deficiency

MeSH Terms

  • Adult
  • Anticoagulants
  • Bariatric Surgery
  • Blood Coagulation Disorders
  • Contraceptives, Oral
  • Female
  • Humans
  • Male
  • Mesenteric Veins
  • Middle Aged
  • Obesity, Morbid
  • Portal Vein
  • Postoperative Complications
  • Risk Factors
  • Smoking
  • Venous Thrombosis

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-k

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09