Skip to main content


Log in

Complications After Sleeve Gastrectomy for Morbid Obesity

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript



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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Frezza E. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37:275–81.

    Article  Google Scholar 

  2. Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.

    Article  Google Scholar 

  3. Shikora S. The use of staple-line reinforcement during laparoscopic gastric bypass. Obes Surg. 2004;14:1313–20.

    Article  Google Scholar 

  4. Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;4:33–8.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  7. Langer FB, Reza Hoda MA, Bohdjalian A. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  9. Hammoui N, Anthone GJ, Kaufman HS, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006;16:1445–9.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  15. Catheline JM, Cohen R, Khochtali I, et al. [Treatment of super super morbid obesity by sleeve gastrectomy]. Presse Med. 2006;35:383–7.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  17. Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  20. Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–29.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

Download references


The authors have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Eldo E. Frezza.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frezza, E.E., Reddy, S., Gee, L.L. et al. Complications After Sleeve Gastrectomy for Morbid Obesity. OBES SURG 19, 684–687 (2009).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: