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© 2019 Haddad A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Venous Thromboembolism and Bariatric Surgery in the Middle East Region

Ashraf Haddad1*, Ahmad Bashir1, Mohamed Al Hadad2, Hayssam Fawal3 and Abdelrahman Nimeri4

1Minimally Invasive & Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC) -Jordan Hospital, Amman, Jordan

2ariatric Surgery, Health Point Hospital, Abu Dhabi, United Arab Emirates

3Bariatric Surgery Clinic "BSC", Bariatric and Metabolic Unit, Makassed General Hospital Beirut, Lebanon

4Bariatric & Metabolic Institute (BMI), Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates



Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery.


We designed a survey to study VTE after bariatric surgery in the Middle East & North Africa region (MENA). We used Survey Monkey and uploaded the survey in our PASMBS social media platforms.


Eighty-two surgeons (63%) responded, they performed 121,369 cases and encountered 230 VTEs (0.19%). VTEs included 13 upper extremity, 103 lower extremity, 57 pulmonary embolism (PE), and 57 porto-mesenteric venous thrombosis (PMT). There was 9 VTE related mortalities constituting 4% mortality rate. The most commonly performed procedure was Sleeve Gastrostomy (56%). It was followed by Adjustable Gastric band (13%), One Anastomosis Gastric Bypass (10%), and Roux-en-Y Gastric bypass (9%). A scoring tool for VTE was used by 62% of surgeons and Caprini was the most commonly used tool and 62% of surgeons reported having at least one incident of VTE. Sequential compression devices were used by 57% of surgeons. Low molecular weight heparin was the most commonly used chemoprophylaxis. LMWH 40 mg once a day was used in 53% of the moderate risk group, 26% of the high-risk group and 6% in the highest risk group. Post-discharge, chemoprophylaxis was continued in the moderate, high and highest risk patients 82%, 95%, and 98% respectively.


VTE risk assessment and the use of chemoprophylaxis for VTE is common in the MENA region. However, many patients continue to receive sub-therapeutic doses of low molecular heparin during the hospital stay and after discharge.