Risks of the Sleeve Gastrectomy

As with any surgical procedure, the sleeve gastrectomy has a risk profile which is important to understand before proceeding. The following is a comprehensive list of issues which can occur. Most of these complications are very rare and 90–95% of patients have no issues. This list is extensive and is not intended to worry you, but simply inform you about the range of possible complications, regardless of how rare the issue may be.

Possible Short Term Complications

Short term surgical complications can include (but are not limited to):

  • Bleeding – Post-operative bleeding can require blood transfusion and occasionally re-operation. Bleeding can occur in roughly 1 in 200 patients.
  • Leaks at the staple line – This is the most feared complication of sleeve gastrectomy. It occurs in roughly 1 in 100 patients. This can at times require a repeat surgery, occasionally in the first few days after surgery. If these leaks persist they can turn into either communications with the skin or wound (fistula) or persistent infections within the abdominal cavity (abscesses). If this complication occurs the length of stay in hospital can be extended to weeks or potentially months after surgery. This can be a life-threatening problem.
  • Infection – This may require treatment with antibiotics and occasionally re-operation.
  • Wound issues – People with a higher BMI are at a higher risk of complications involving wound infections, haematomas (large bruises) and poor wound healing.
  • Damage to organs – Any keyhole procedure can be complicated by unintentional injury to the organs near the area of operation. This may require a repeat operation to repair the damaged organs.
  • Blood clots – Deep Venous Thrombosis (clots in the veins) and pulmonary embolus (clots in the lungs).
    Pneumonia/ chest infection.

Possible Long Term Complications

  • Any intra-abdominal procedure related to the gastrointestinal tract can be complicated in the long-term by problems associated with adhesions (scar tissue) related to the gut.
  • Any intra-abdominal procedure has a low risk of subsequent hernia formation related to the wound closure.
  • Increased chance of gastro-oesophageal reflux (heartburn). If reflux occurs post operatively some patients can require acid suppressing medication. This operation is avoided for those people with severe symptoms of reflux prior to surgery.
  • There are occasional issues related to malabsorption of micronutrients – these are usually easily managed with supplemental vitamins and minerals. Long-term monitoring of blood tests is required.

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