Leeman M, Biter LU, Apers JA, et al. - Given that the risk of venous thromboembolic events (VTE) in the postoperative period in metabolic surgery could be reduced with the implementation of fast-track protocols and that administration of thromboprophylaxis can be a burden for patients, researchers undertook this study comparing extended to restricted thromboprophylaxis with low molecular weight heparin (LMWH) for patients undergoing metabolic surgery. They conducted a single-center retrospective cohort study including data of 3,666 patients who underwent a primary Roux-en-Y gastric bypass or sleeve gastrectomy between 2014 and 2018 following the fast-track protocol. Thromboprophylaxis for 2 weeks was reported among patients operated in 2014–2017. In 2018, thromboprophylaxis was provided to patients only during hospital admission. They analyzed patients already using anticoagulants as a separate subgroup. VTE occurred in total, two patients in the 2014–2017 cohort vs zero patients in the 2018 cohort. As per findings, no increase in the rate of VTEs occurred despite the restricted use of thromboprophylaxis administration since 2018. Quick mobilization and hospital discharge, as encouraged by the fast-track protocol, may explain this finding. Postoperative hemorrhage rates by thromboprophylaxis protocol did not differ significantly. Findings support the safety of short term use of thromboprophylaxis in metabolic surgery in patients at low risk of VTE.