Mesenteric Vascular Occlusion after Bariatric Surgery: A Systematic Review and Meta-Analysis

Abstract

Abstract Background Portomesenteric vein thrombosis (PMVT) is a potentially severe complication that can occur after bariatric surgery. PMVT has gained importance because of the increasing number of bariatric surgeries being performed Aim and Objectives The main aim of this study was to assess how to investigate and manage the complications of the mesenteric vascular occlusion as well as to evaluate the clinical and radiological outcomes of patients undergoing bariatric surgery and the association of this surgical procedure and mesenteric vascular occlusion. Subjects and Methods This meta-analysis obtained 295 articles from PubMed, 603 articles from Scopus, 1 article from Cochrane library and 444 from web of science. 509 duplicated articles were removed using Endnote X8 program (Tompson Reuter, USA), 834 articles manually underwent titles and Abstracts screening and 247 articled underwent full-text review. 35 studies finally met our inclusion criteria. Results A total of thirty two studies reported the incidence of porto-mesenteric thrombosis with a total number of 41438 underwent different techniques of bariatric surgery. The overall incidence of porto-mesenteric thrombosis was 0.3% [OR = 0.003, (95% CI = 0.002: 0.004). Most of the studies were consistent in reporting an incidence rate nearby by 0.3% except few studies which reported higher incidence rate. Conclusion PMVT is a rare presentation after LSG, which requires early diagnosis and management. Conservative management through anticoagulants and thrombolytic therapy is quite effective and, if indicated, should always be considered as the primary treatment option.