Venous Thromboembolism

In this chapter book, we explore various facets of venous thromboembolism (VTE), focusing on its significant impact on patients undergoing metabolic bariatric surgery. VTE, encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), poses considerable risks including prolonged hospital stays, escalated costs, unplanned readmissions, and mortality. VTE prophylaxis should be considered in the perioperative period of bariatric surgery. Additionally, there are predictive tools for identifying patients with a higher risk of VTE who may need extended chemical DVT prophylaxis. Clinical manifestations of DVT such as lower extremity pain, swelling, and localized tenderness are not specific. PE can present with a spectrum of symptoms, from mild tachycardia to life-threatening cardiogenic shock. D-dimer testing has limitations in risk assessment, especially in the postoperative period. Imaging modalities like compression ultrasonography with doppler, ventilation–perfusion scintigraphy, and computed tomography (CT) pulmonary angiography are pivotal in diagnosing DVT and PE. Prophylactic measures, encompassing mechanical and pharmacological interventions, alongside early diagnosis and treatment constitute essential aspects discussed herein.