Skip to main content


Log in

Gastric Stenosis After Laparoscopic Sleeve Gastrectomy: Diagnosis and Management

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript



The use of laparoscopic sleeve gastrectomy (LSG) is increasing worldwide. Although post-LSG gastric stenosis (GS) is less frequent, it has not been well defined and lacks standardized management procedures. The objective of the present study was to describe a series of patients with GS symptoms after LSG and to develop a standardized management procedure for this complication.


We performed a retrospective analysis of a prospective database of patients presenting with GS after LSG procedures performed between January 2008 and March 2014. The primary efficacy criterion was the frequency of post-LSG GS. GS was classified as functional (i.e. a gastric twist) or organic. The secondary efficacy criteria included the time interval between LSG and diagnosis of GS, the type of stenosis, the type of management, and the follow-up data.


During the study period, 1210 patients underwent primary or secondary LSG. Seventeen patients had post-operative symptoms of GS (1.4 %); one patient had achalasia that had not been diagnosed preoperatively and thus was excluded from our analysis. The median time interval between LSG and diagnosis of GS was 47.2 days (1–114). Eleven patients had organic GS and six had functional GS. Seven patients required nutritional support. Endoscopic treatment was successful in 15 patients (88.2 %) after balloon dilatation (n = 13) or insertion of a covered stent (n = 2). Two of the 15 patients required conversion to Roux-en-Y gastric bypass (11.8 %).


GS after LSG is a rare complication but requires standardized management. Most cases can be treated successfully with endoscopic balloon dilatation.

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.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others



body mass index


gastric fistula


gastric stenosis


laparoscopic sleeve gastrectomy


obstructive sleep apnea syndrome


  1. Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256:262–5.

    Article  PubMed  Google Scholar 

  2. Prevot F, Verhaeghe P, Pequignot A, et al. Two lessons from a 5-year follow-up study of laparoscopic sleeve gastrectomy: persistent, relevant weight loss and a short surgical learning curve. Surgery. 2014;155:292–9.

    Article  PubMed  Google Scholar 

  3. 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  PubMed  Google Scholar 

  4. Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257:231–7.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  6. Burgos AM, Csendes A, Braghetto I. Gastric stenosis after laparoscopic sleeve gastrectomy in morbidly obese patients. Obes Surg. 2013;23:1481–6.

    Article  PubMed  Google Scholar 

  7. Parikh A, Alley JB, Peterson RM, et al. Management options for symptomatic stenosis after laparoscopic vertical sleeve gastrectomy in the morbidly obese. Surg Endosc. 2012;26:738–46.

    Article  PubMed  Google Scholar 

  8. Gastrectomie Longitudinale [sleeve gastrectomy] pour obésité. Hautes autorité de la santé. Recommandations 2008.

  9. Dhahri A, Verhaeghe P, Hajji H, et al. Sleeve gastrectomy: technique and results. J Visc Surg. 2010;147:e39–46.

    Article  CAS  PubMed  Google Scholar 

  10. Rebibo L, Mensah E, Verhaeghe P, et al. Simultaneous gastric band removal and sleeve gastrectomy: a comparison with front-line sleeve gastrectomy. Obes Surg. 2012;22:1420–6.

    Article  PubMed  Google Scholar 

  11. Lazzati A, Guy-Lachuer R, Delaunay V, et al. Bariatric surgery trends in France: 2005–2011. Surg Obes Relat Dis. 2014;10:328–34.

    Article  PubMed  Google Scholar 

  12. Rebibo L, Blot C, Verhaeghe P, et al. Effect of perioperative management on short-term outcomes after sleeve gastrectomy: a 600-patient single-center cohort study. Surg Obes Relat Dis. 2014;10:853–8.

    Article  PubMed  Google Scholar 

  13. Binda A, Jaworski P, Tarnowski W. Stenosis after sleeve gastrectomy—cause, diagnosis and management strategy. Pol Przegl Chir. 2013;85:730–6.

    PubMed  Google Scholar 

  14. Iannelli A, Martini F, Schneck AS, et al. Twisted gastric sleeve. Surgery. 2015;157:163–5.

    Article  PubMed  Google Scholar 

  15. Contival N, Gautier T, Le Roux Y, et al. Stenosis without stricture after sleeve gastrectomy. J Visc Surg. 2015. doi:10.1016/j.jviscsurg.2015.01.008.

    PubMed  Google Scholar 

  16. Gero D, Ribeiro-Parenti L, Marmuse JP. A simple trick to prevent VOMIT after sleeve gastrectomy. Obes Surg. 2015;25:1252–3.

    Article  PubMed  Google Scholar 

  17. Rebibo L, Fumery M, Hakim S, et al. Combined stents for the treatment of large gastric fistulas or stenosis after sleeve gastrectomy. Endoscopy. 2015;47 Suppl 1:E59–60.

    PubMed  Google Scholar 

  18. Makarewicz W, Kaska L, Kobiela J, et al. Wernicke’s syndrome after sleeve gastrectomy. Obes Surg. 2007;17:704–6.

    Article  PubMed  Google Scholar 

  19. Koppman JS, Poggi L, Szomstein S, et al. Esophageal motility disorders in the morbidly obese population. Surg Endosc. 2007;21:761–4.

    Article  CAS  PubMed  Google Scholar 

  20. Hagen ME, Sedrak M, Wagner OJ, et al. Morbid obesity with achalasia: a surgical challenge. Obes Surg. 2010;20:1456–8.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Oh HB, Tang SW, Shabbir A. Laparoscopic Heller’s cardiomyotomy and Roux-en-Y gastric bypass for missed achalasia diagnosed after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10:1002–4.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

None of the authors have any conflicts of interest to declare.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Informed consent for this study does not apply.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Jean-Marc Regimbeau.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rebibo, L., Hakim, S., Dhahri, A. et al. Gastric Stenosis After Laparoscopic Sleeve Gastrectomy: Diagnosis and Management. OBES SURG 26, 995–1001 (2016).

Download citation

  • Published:

  • Issue Date:

  • DOI: