Prevalence of Pulmonary Embolism After Bariatric Surgery: A Systematic Review and Meta-Analysis Publisher Pubmed



Khalilzadeh Bonab D ; Dehbozorgi M ; Shafiee A ; Tajvidi M ; Hosseini K ; Karimi A ; Movahed F ; Alirezaei A ; Bakhtiyari M
Source: Obesity Surgery Published:2026

Abstract

Background: Pulmonary embolism (PE) is a potentially life-threatening complication following bariatric surgery. Accurate estimates of its prevalence are essential to inform perioperative risk management and thromboprophylaxis strategies. Methods: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Observational studies and randomized controlled trials reporting postoperative PE among adults (≥ 18 years) undergoing bariatric procedures—including sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding—were included. Results: Nine studies comprising 1,080,346 patients were included. The pooled prevalence of PE following metabolic-bariatric surgery (MBS) was 3.70 per 1000 procedures (95% CI: 1.71–6.30), with substantial heterogeneity (I² = 99.48%). Subgroup analysis revealed the highest prevalence in open bariatric surgery (7.58 per 1000; 95% CI: 4.10–11.99), intermediate in procedures with unreported surgical approach (2.97 per 1000; 95% CI: 0.76–6.62), and lowest in laparoscopic procedures (1.90 per 1000; 95% CI: 0.00–5.95). Prevalence estimates were similar between prospective and retrospective studies. Conclusion: PE is an uncommon but clinically significant complication after MBS, with risk strongly influenced by surgical technique. These findings emphasize the importance of vigilant perioperative monitoring and tailored thromboprophylaxis, particularly in open procedures. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026.