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01-06-2021 | Portal Vein Thrombosis | Original Contributions

Early Effects of Laparoscopic Sleeve Gastrectomy and Laparoscopic One-Anastomosis Gastric Bypass on Portal Venous Flow: a Prospective Cohort Study

Authors: Ayman M. A. Osman, Ayman S. Helmy, Sameh Mikhail, Ayman A. AlAyat, Dalia K. Serour, Mohamed Y. Ibrahim

Published in: Obesity Surgery | Issue 6/2021

Abstract

Background

Portal vein thrombosis (PVT) is an infrequent, yet potentially lethal, complication of bariatric surgery. The aim of this prospective, non-randomized, cohort study is to compare between laparoscopic sleeve gastrectomy (LSG) and laparoscopic one-anastomosis gastric bypass (LOAGB) in terms of their early postoperative effects on portal venous flow and patency.

Methods

Forty-nine morbidly obese patients were allocated to one of 2 groups (A or B). Group A patients underwent LSG, whereas group B patients underwent LOAGB. Portal venous Doppler ultrasound scanning was performed preoperatively and 2 weeks postoperatively in all cases, in order to assess the portal venous flow (PVF) in terms of flow direction and peak systolic velocity (PSV); as well as to assess the portal venous patency and exclude PVT. The mean change in PSV (ΔPSV) and the mean percentage change in PSV (%ΔPSV) were determined in both groups.

Results

In all cases (group A (n = 26); group B (n = 23)), the direction of PVF was “hepatopetal” both preoperatively and 2 weeks postoperatively. The mean ΔPSV and the mean %ΔPSV were higher in LSG patients “group A” (− 0.84 cm/s and 3.25% respectively) compared with LOAGB patients “group B”(− 0.06 cm/s and 0.27% respectively); P = 0.038 and 0.039 respectively. The mean change in PSV was in the negative direction in both groups, i.e., “deceleration.” No cases of PVT were reported in the study.

Conclusions

Laparoscopic sleeve gastrectomy is associated with greater reduction in portal venous peak systolic flow velocity in the early postoperative period, compared with laparoscopic one-anastomosis gastric bypass.

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Title: Early Effects of Laparoscopic Sleeve Gastrectomy and Laparoscopic One-Anastomosis Gastric Bypass on Portal Venous Flow: a Prospective Cohort Study
Authors: Ayman M. A. Osman
Ayman S. Helmy
Sameh Mikhail
Ayman A. AlAyat
Dalia K. Serour
Mohamed Y. Ibrahim
Publication date: 01-06-2021
Publisher: Springer US
Keywords: Portal Vein Thrombosis
Sleeve Gastrectomy
Portal Vein Thrombosis
Published in: Obesity Surgery / Issue 6/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-021-05267-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early Effects of Laparoscopic Sleeve Gastrectomy and Laparoscopic One-Anastomosis Gastric Bypass on Portal Venous Flow: a Prospective Cohort Study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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