Bariatric Procedures

Thromboembolic Risks

Venous thromboembolism (VTE) is a leading cause of postoperative mortality in bariatric surgical patients.

Advanced age, major orthopedic surgery, neoplastic disease, prolonged operations, varicose veins, immobilization, estrogen-containing medications, and obesity are known risk factors for the development of postoperative thromboembolic complications.

Bleeding Risks

After bariatric surgery, early or late adverse events, such as intraluminal or extraluminal gastrointestinal hemorrhage, can occur.

General Recommendations for Pre-Procedure Warfarin Management

Laparoscopic bariatric surgery: Hold warfarin x5 days and resume anticoagulation 24 hours after surgery.

References

Management of acute postoperative hemorrhage in the bariatric patient.
Ferreira LE, Wong Kee Song LM, Baron TH. Gastrointest Endosc Clin N Am. 2011 Apr;21(2):287-94. 

Prospective analysis of the incidence of deep venous thrombosis in bariatric surgery patients.  Prystowsky JB, Morasch MD, Eskandari MK, Hungness ES, Nagle AP.  Surgery. 2005 Oct; 138(4): 759-65. 

Special thanks to Eduardo Grunvald, MD for his expert guidance.