Sleeve gastrectomy complications

Sleeve gastrectomy complications​ are often evaluated by imaging. For details about the surgical procedure, please see the parental article on sleeve gastrectomy

Postoperative complications can be classified by etiology or temporality.

Early complications
  • staple line leakage
    • clinical presentation: epigastric pain, fever, leukocytosis, +/- referred left shoulder pain due to phrenic nerve irritation
    • usually occurs within the first week postoperatively due to dehiscence of the staples, near the gastro-esophageal junction
    • CT findings include extravasation of orally administrated contrast media, extraluminal air foci and perigastric collection or abscess formation
    • fluoroscopy is the modality of choice for diagnosis of post sleeve leakage
  • hemorrhage/hematoma: high-density perigastric collection, if it is large it can be drained under image guidance
  • splenic injury
  • ​portovenous thrombosis
    • occurs due to dehydration
    • can affect portal vein or one of its branches, splenic, or superior mesenteric vein
Late complications
  • gastric dilatation
    • patient regain weight with dilatation of the sleeved stomach
    • fluoroscopy and CT with oral contrast may show increased dilatation of the stomach, greater than expected post-operatively
  • gallstones: rapid loss of weight results in gallstone formation (usually multiple and small)
  • hiatal hernia
    • due to interruption of the normal fixation mechanism of the stomach
    • usually presents with symptoms of GERD
    • easily diagnosed by fluoroscopy and CT
  • gastric stricture
    • can occur early (secondary to edema or ischemia) or late (secondary to fibrosis)
    • usually affecting the distal gastric pouch
  • gastro-esophageal reflux disease: can arise de novo or exacerbate existing disease 5
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Article information

rID: 63252
Section: Approach
Synonyms or Alternate Spellings:
  • Complications of sleeve gastrectomy

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Cases and figures

  • Case 1: leak with abscess
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  • Case 2: GERD
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