Juodeikis Žygimantas, Brimas Gintautas
Clinic of Gastroenterology, Nephro-Urology and Surgery, Vilnius University, Vilnius, Lithuania Department of Surgery, Republican Vilnius University Hospital, Vilnius, Lithuania.
Acta Med Litu. 2024;31(2):409-415. doi: 10.15388/Amed.2024.31.2.23. Epub 2024 Dec 4.
Bariatric and metabolic surgery has emerged as an effective intervention for morbid obesity, offering substantial and sustained weight loss along with improvements in various comorbidities. Among the diverse spectrum of potential postoperative complications, thromboembolic events have garnered increasing attention due to their significant morbidity and mortality.The aim of this study is to present a single-center experience of thromboembolic complications following bariatric and metabolic surgery. Additionally, we present two distinctive cases, highlighting the clinical manifestations, diagnostic challenges, and therapeutic interventions associated with postoperative thromboembolism.
We retrospectively reviewed data from patients with obesity who underwent various bariatric and metabolic operations at Republican Vilnius University Hospital from January 2018 to February 2024. All patients, regardless of the type of operation performed, were included. Two patients with thromboembolic complications are presented as illustrative cases.
A total of 633 patients were included in the analysis: 278 underwent laparoscopic adjustable gastric banding, 345 underwent sleeve gastrectomies, and 10 underwent gastric bypasses. Thromboembolic complications occurred in only two patients, with one developing portal vein thrombosis and the other developing pulmonary embolism.
This single-center experience emphasizes the unpredictable nature of thromboembolic events in postbariatric surgery patients and highlights the critical role of vigilant monitoring, early detection, and individualized therapeutic interventions. Continued research efforts are warranted to refine risk stratification, enhance preventive measures, and improve overall patient outcomes in the landscape of bariatric surgery.
减重与代谢手术已成为治疗病态肥胖的有效干预手段，可实现显著且持续的体重减轻，并改善各种合并症。在众多潜在的术后并发症中，血栓栓塞事件因其较高的发病率和死亡率而日益受到关注。本研究旨在介绍减重与代谢手术后血栓栓塞并发症的单中心经验。此外，我们还展示了两个独特病例，突出了与术后血栓栓塞相关的临床表现、诊断挑战及治疗干预措施。
我们回顾性分析了2018年1月至2024年2月在维尔纽斯大学共和医院接受各种减重与代谢手术的肥胖患者的数据。所有患者，无论接受何种手术类型，均纳入研究。两名有血栓栓塞并发症的患者作为典型病例呈现。
共有633例患者纳入分析：278例行腹腔镜可调节胃束带术，345例行袖状胃切除术，10例行胃旁路术。仅两名患者发生血栓栓塞并发症，其中一例发生门静脉血栓形成，另一例发生肺栓塞。
这一单中心经验强调了减重手术后患者血栓栓塞事件的不可预测性，并突出了 vigilant监测、早期发现和个体化治疗干预的关键作用。在减重手术领域，有必要持续开展研究工作，以完善风险分层、加强预防措施并改善患者总体预后。
