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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
Osman, Ayman M. A.; Helmy, Ayman S.; Mikhail, Sameh; AlAyat, Ayman A.; Serour, Dalia K.; Ibrahim, Mohamed Y.
- 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.
- Subjects
GASTRIC bypass; SLEEVE gastrectomy; LAPAROSCOPIC surgery; SURGICAL complications; BARIATRIC surgery; DOPPLER ultrasonography
- Publication
Obesity Surgery, 2021, Vol 31, Issue 6, p2410
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-021-05267-3