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Sleeve Gastrectomy Complications

By Richard Daub ; Updated July 27, 2017

A sleeve gastrectomy is a very serious and non-reversible surgical procedure typically performed on people who are extremely obese. The laparoscopic procedure removes a portion of the stomach around the area of the major curve, reducing its overall size by approximately 15 percent and typically results in significant weight loss. However, this procedure may be followed by a second procedure, a duodenal switch or gastric bypass, if the patient's weight plateaus or increases over time. Studies have shown that the sleeve gastrectomy is a relatively safe procedure, but it does have potentially serious health risks.


A 2008 study by the Bariatric Institute and Section of Minimally Invasive Surgery at the Cleveland Clinic Florida concluded that laparoscopic sleeve gastrectomy "is a relatively safe surgical option for weight loss as a primary procedure and as a primary step before a secondary nonbariatric procedure in high-risk patients". And while it is a relatively new procedure in which the results of efficacy and complications are still yet unknown, a number of studies have shown that it is generally successful as a standalone procedure for weight loss and is relatively safe, mostly because it involves removing a part of the stomach without introducing a foreign body like the gastric banding procedure, which wraps the stomach with a plastic band to reduce its size.


However, laparoscopic sleeve gastrectomy does have risks and complications. A 2009 study by the Department of Surgery at the University of Alabama at Birmingham found that a common complication of the procedure was leaks and hemorrhages along the staple line where the two edges of the stomach were stapled back together. These leaks and hemorrhages were caused by intra-abdominal pressure and required a second procedure to reinforce the strength the staple line that holds the two edges together.


A separate 2009 study at the Cleveland Clinic Florida found that in addition to leakages along the staple line, other patients reported instances of gastroesophageal reflux disease, symptomatic gallstones and trocar site infection, which is an infection along the staple line.

Additional Complications

Another 2009 study by the Federation of Digestive Diseases at Amiens North Hospital at the University of Picardy in Amiens, France found that 5 percent of 135 patients studied developed postoperative gastric fistula, which is an irregular passage between the stomach and abdominal wall. Those patients needed additional surgery to correct the condition.


An overwhelming majority of studies have concluded that laparoscopic sleeve gastrectomy is a very promising procedure to treat extreme obesity and is a relatively safe procedure with few major complications. The most common complication was leakages along the stomach line, which involved a follow up procedure to reinforce the seal. Even with serious complications, fatalities are rare.

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