Obesity Surgery

, Volume 19, Issue 6, pp 684–687 | Cite as

Complications After Sleeve Gastrectomy for Morbid Obesity

  • Eldo E. FrezzaEmail author
  • Sheila Reddy
  • Laura L. Gee
  • Mitchell S. Wachtel
Research Article



Laparoscopic sleeve gastrectomy (LSG) is an increasingly used bariatric surgical procedure.


We report our complications after LSG and compared to 17 other published LSG series. The individual types of complications for the published series were evaluated, with sample size calculations being performed to determine the number of patients required for a study that would detect halving the odds of the most common complications.


Of 53 patients who underwent LSG, 42 were women. Mean age was 51 years with a mean initial body mass index of 53.5 kg/m2 and mean of eight comorbidities. Mean excess weight loss was 52.2% at 12 months and 59.2% at 18 months. No patients died. Five patients (9.4%) developed complications which included two staple line leaks that required reoperations, one preceded by a salmonella infection associated with vomiting, the other by postoperative pneumonia associated with coughing. Of the three staple line hemorrhages, one required hospitalization. The median complication rate for the 17 articles was 4.5%. With the number of patients for each series taken into account, the current series had a complication rate of 1.24 (95% CI 0.45–2.87) times that of the 17 published series. Published LSG complications were diverse, with the most common being reoperation, occurring after 3.6% of procedures. A study designed to detect halving the odds of reoperation would require more than 3,000 procedures.


LSG is a safe procedure with low morbidity. Because leaks and reoperation in this series were preceded by large increments in intraabdominal pressure, attention to staple line reinforcements that increase burst pressure may be warranted.


Sleeve gastrectomy Complications Buttress material Leak Oozing Morbid obesity 



The authors have no conflict of interest.


  1. 1.
    Frezza E. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37:275–81.CrossRefGoogle Scholar
  2. 2.
    Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.CrossRefGoogle Scholar
  3. 3.
    Shikora S. The use of staple-line reinforcement during laparoscopic gastric bypass. Obes Surg. 2004;14:1313–20.CrossRefGoogle Scholar
  4. 4.
    Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;4:33–8.CrossRefGoogle Scholar
  5. 5.
    Carmichael AR, Sue-Ling HM, Johnston D. Quality of life after the Magenstrasse and Mill procedure for morbid obesity. Obes Surg. 2001;11:708–15.CrossRefGoogle Scholar
  6. 6.
    Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.CrossRefGoogle Scholar
  7. 7.
    Langer FB, Reza Hoda MA, Bohdjalian A. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.CrossRefGoogle Scholar
  8. 8.
    Langer FB, Bohdjalian A, Felberbauer FX. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16:166–71.CrossRefGoogle Scholar
  9. 9.
    Hammoui N, Anthone GJ, Kaufman HS, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006;16:1445–9.CrossRefGoogle Scholar
  10. 10.
    Roa PE, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg. 2006;16:1323–6.CrossRefGoogle Scholar
  11. 11.
    Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy (LSG): review of a new bariatric procedure and initial results. Surg Technol Int. 2006;15:47–52.PubMedGoogle Scholar
  12. 12.
    Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.CrossRefGoogle Scholar
  13. 13.
    Lee CM, Cirangle PT, Jossart GH. Vertical gastrectomy for morbid obesity in 216 patients: report of two-year results. Surg Endosc. 2007;21:1810–6.CrossRefGoogle Scholar
  14. 14.
    Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefGoogle Scholar
  15. 15.
    Catheline JM, Cohen R, Khochtali I, et al. [Treatment of super super morbid obesity by sleeve gastrectomy]. Presse Med. 2006;35:383–7.CrossRefGoogle Scholar
  16. 16.
    Han SM, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRefGoogle Scholar
  17. 17.
    Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.CrossRefGoogle Scholar
  18. 18.
    Milone L, Strong V, Gagner M. Laparoscopic vertical sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > 50). Obes Surg. 2005;15:612–7.CrossRefGoogle Scholar
  19. 19.
    Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003;13:861–4.CrossRefGoogle Scholar
  20. 20.
    Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–29.CrossRefGoogle Scholar
  21. 21.
    Vidal J, Ibarzabal A, Romero F, et al. Type 2 diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects. Obes Surg. 2008;18:1077–82.CrossRefGoogle Scholar
  22. 22.
    Consten E, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14:1360–6.CrossRefGoogle Scholar
  23. 23.
    Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Eldo E. Frezza
    • 1
    Email author
  • Sheila Reddy
    • 2
  • Laura L. Gee
    • 2
  • Mitchell S. Wachtel
    • 3
  1. 1.Department of SurgeryThe University of Alabama at BirminghamBirminghamUSA
  2. 2.Division of General Surgery, Department of SurgeryTexas Tech University Health Sciences CenterLubbockUSA
  3. 3.Department of PathologyTexas Tech University Health Sciences CenterLubbockUSA

Personalised recommendations