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中华肥胖与代谢病电子杂志 ›› 2026, Vol. 12 ›› Issue (01) : 72 -77. doi: 10.3877/cma.j.issn.2095-9605.2026.01.010

病例报告

腹腔镜胃袖状切除术后门静脉-肠系膜静脉血栓形成1例报道
杨磊, 熊见武, 沈宗文, 陈熊熊, 李滢旭()   
  1. 655000 曲靖,曲靖市第二人民医院 微创代谢外科
  • 收稿日期:2025-03-24 出版日期:2026-02-28
  • 通信作者: 李滢旭

Portal-mesenteric venous thrombosis following laparoscopic sleeve gastrectomy: a case report

Lei Yang, Jianwu Xiong, Zongwen Shen, Xiongxiong Chen, Yingxu Li()   

  1. Department of Minimally Invasive Metabolic Surgery, Second People’s Hospital of Qujing, Qujing 655000, China
  • Received:2025-03-24 Published:2026-02-28
  • Corresponding author: Yingxu Li
引用本文:

杨磊, 熊见武, 沈宗文, 陈熊熊, 李滢旭. 腹腔镜胃袖状切除术后门静脉-肠系膜静脉血栓形成1例报道[J/OL]. 中华肥胖与代谢病电子杂志, 2026, 12(01): 72-77.

Lei Yang, Jianwu Xiong, Zongwen Shen, Xiongxiong Chen, Yingxu Li. Portal-mesenteric venous thrombosis following laparoscopic sleeve gastrectomy: a case report[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2026, 12(01): 72-77.

门静脉-肠系膜静脉血栓形成(PMVT)是腹腔镜袖状胃切除术后少见且危及生命的并发症,其危险因素包括肥胖、代谢紊乱、手术操作、术后并发症等,但因症状不典型而易被漏诊。本文报导1例通过肠系膜上动脉置管溶栓术+低分子肝素抗凝成功治疗腹腔镜胃袖状切除术后门静脉-肠系膜静脉血栓形成的病例,旨在帮助减重代谢外科医师提高对PMVT的认识,以免延误治疗时机造成严重后果。

Portal-mesenteric venous thrombosis (PMVT) is a rare yet life-threatening complication following laparoscopic sleeve gastrectomy. Risk factors include obesity, metabolic disorders, intraoperative manipulation, and postoperative complications. However, its non-specific symptoms often lead to missed diagnosis. This article reports a case of PMVT after laparoscopic sleeve gastrectomy that was successfully treated with superior mesenteric artery catheter-directed thrombolysis combined with low-molecular-weight heparin anticoagulation. The purpose of this report is to enhance awareness among bariatric and metabolic surgeons regarding PMVT, emphasizing the importance of timely diagnosis and intervention to prevent severe consequences caused by delayed treatment.

图1 手术步骤。A、B、C探查发现胃网膜血管粗大、未见肝硬化表现;D、E游离大网膜、结扎离断血管;F切割胃大弯、制作袖状胃;G加固胃切缘、复位大网膜;H修补脐疝;I脾窝处留置腹腔引流管
图2 术后第7天腹部CT发现大网膜组织内血肿形成(黄色箭头指示血肿)
图3 术后第18天腹部增强CT(黄色箭头指示血栓)。A门静脉血栓形成;B肠系膜上静脉血栓形成
图4 溶栓+抗凝治疗后复查腹部增强CT(黄色箭头指示门静脉)。A治疗后10天门静脉血栓情况;B治疗后1个月门静脉血栓情况;C治疗后7个月门静脉血栓情况
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