Long-term complications after gastric sleeve surgery


Gastric sleeve, also known as sleeve gastrectomy , is weight loss surgery. During this operation, the surgeon removes about 80% of the stomach . This surgery is usually done laparoscopically . This means that the surgeon inserts the instruments through small incisions in the abdomen.

As with all surgeries , gastric sleeve surgery can be dangerous. Patients can experience a wide range of complications or problems after surgery. They can include physical or mental complications.

After gastric sleeve surgery, the stomach or "pouch" can only hold about 4 ounces or 120 milliliters of food. This is much less than the stomach can normally hold. Some complications can occur due to the smaller stomach.

In this article, we will discuss some of the complications that can arise after gastric sleeve surgery. This includes short-term and long-term complications, as well as problems that can be physical or mental.

Get Medical Information / Laura Porter

What are the risks and benefits of a stomach sleeve?

After gastric sleeve surgery, you shouldn't be able to eat more than half a cup of food at a time. When you eat less food than before, you are consuming fewer calories. This is how you lose weight.

This operation is in progress. It can improve the health of obese people who have a hard time losing and maintaining excess weight. The safety of sleeves for the stomach and other weight loss surgeries is similar to that of other types of surgeries.

Deaths from this operation are rare. A skilled surgeon has few complications. When complications arise, they can have various consequences. Some of the complications are minor. Others can change lives.

Acute complications are those that occur shortly after surgery. They may include:

  • Bleeding
  • Pain
  • Blood clots
  • Anastomotic leaks (leaks that occur at connections made during surgery)

These complications are long-lasting. This means that they can last up to six months after surgery. They can also appear six months after surgery.

You may still eat too much after surgery. If you do this, you may not lose a lot of weight. Your surgeon will give you a postoperative plan. Following a plan will help you avoid complications.

Comparison of stomach sleeves with other operations.

A stomach sleeve is just one type of bariatric surgery or weight loss surgery. There are differences between each type. Discuss all of your options with your doctor before deciding on surgery. This will help you make the best decision.

Remember these two things:

  • The stomach sleeve is permanent . This is different from the lap band procedure . The gastric band "squeezes" the stomach, dividing it into two pockets. If a problem occurs, the gastric band can be removed. The part of the stomach that was removed by the sleeve procedure cannot be replaced if there are problems.
  • You cannot lose weight with the stomach sleeve . Gastric bypass patients generally lose more weight compared to gastric sleeve patients. They also tend to retain more weight in the long term. But bypass surgery patients can have their own long-term problems.

How Gastric Sleeve Affects Weight and Nutrition

Weight loss is the goal of gastric sleeve surgery, but you may not lose as much weight as you thought. You may also lose weight but get it back.

Since you eat fewer calories, you also get fewer nutrients. This can lead to a deficiency or lack of nutrients that your body needs.

Inability to lose weight

Sometimes surgery does not help the patient lose weight. This can happen if the stomach sac is too large. It can also happen if the patient does not follow the postoperative instructions. There may also be other problems that make weight loss difficult.

Weight regain

In the first days after the operation, no more than half a glass of food fits in the gastric sac. Over time, the bag stretches. If you eat more, the weight loss may stop. You can even gain weight.

Weight gain, if any, usually begins in the third year after surgery. Weight loss surgery is a great weight loss tool, but patients also need to change their habits. Patients who do not change their habits permanently can regain some or all of the lost weight.

Power issues

Many gastric bypass surgeries alter your body's ability to absorb nutrients. This does not happen with gastric sleeve surgery. However, patients may have nutritional problems. This is because when you eat fewer calories, you consume fewer nutrients. It can be worse if you have diarrhea and nausea.

In this case, a whole food diet may not be enough to maintain your health. Malnutrition, the lack of sufficient amounts of nutrients is very serious. Your healthcare provider can advise you on vitamins and minerals, medications, or other remedies to help you stay healthy.

Food intolerances

You do not need to give up certain foods after gastric sleeve surgery. This is different from other types of weight loss surgeries. But that doesn't mean you can eat whatever you want.

A 2018 study found that gastric sleeve patients do not digest certain foods well, such as:

  • Red meat
  • Rice
  • Pasta
  • Bread

Researchers believe this is simply because patients cannot eat as much at once.


Results after surgery vary from person to person. You may lose less weight than you expected. You can also regain lost weight. Some people do not get enough nutrition after surgery. Others may have trouble digesting food.

Physical symptoms after gastric sleeve surgery

Some gastric sleeve patients have stomach problems. This can happen right after surgery and can take a long time. Some patients may also experience sagging skin after losing weight.

Dyspepsia (indigestion)

Some gastric sleeve patients may notice increased indigestion or an upset stomach. This may be due to the smaller size of the stomach. It can also be due to changes in the way food travels through the body.


Nausea is a common complication of this surgery. Most people find that nausea subsides as they recover, but for some people it persists for months or more.

It is not clear why some gastric sleeve patients develop nausea. This may be due in part to the fact that food stays in the stomach longer. Medicines for nausea can help.


Some patients may experience diarrhea after surgery. This can happen for a number of reasons. The microbiota or microscopic organisms in the gut may change after surgery. Undigested nutrients in the small intestine can also cause diarrhea.

Diarrhea can lead to dehydration or malnutrition. If the diarrhea does not go away on its own, your surgeon or gastroenterologist can help.

Sagging skin

When you are obese, your skin stretches. This is why sagging skin is so common after any weight loss surgery. A panniculectomy is an operation to remove excess skin. Your surgeon can wait one to two years for your weight to stabilize before recommending this.

Medical problems after gastric sleeve surgery

Stomach sleeve cutting can cause mild to severe health problems. Talk to your doctor if you are concerned that you may have health problems after surgery.

Chronic conditions won't go away

Many patients hope that this surgery will help correct chronic health problems such as diabetes, high blood pressure, and others. Sometimes these problems persist after surgery. Sometimes they leave for a short time, but come back later.

Gastroesophageal reflux disease (acid reflux)

Heartburn and other symptoms of gastroesophageal reflux disease (GERD) are common after this surgery. These symptoms include:

  • Swelling
  • Feel full
  • Stomach ache

Acid-reducing medications can help improve GERD symptoms.

Stomach ulcer

Stomach ulcers, known as peptic ulcers , are more common after this surgery. Stomach ulcers can cause:

Stomach ulcers are usually found on upper gastrointestinal endoscopy .


Gallstones are more likely to occur after any weight-loss surgery. Because of this, patients sometimes require cholecystectomy . This is an operation to remove the gallbladder.

Stomach obstruction

Stenosis is a narrowing of the stomach outlet that makes it difficult to digest food. Sometimes this can cause a blockage in the stomach. The surgeon can solve this problem by stretching the bottleneck.

Abdominal adhesions (scars)

The tissues of the abdomen are slippery. It helps them move while you move. After surgery, you may develop scars that cause the tissue to become "sticky," causing a pulling sensation. This can be annoying or even painful. Sometimes the scars can block the small intestine.


An abscess is a collection of pus in the body in the form of a bag. When this happens immediately after surgery, it is usually because some of the contents of your intestines have been spilled or leaked. An abscess of the spleen, an organ that filters blood, is a very rare complication of this operation.

Delayed escape

A suture line leak, also called a suture line tear, is when stomach contents leak through the suture site. When this happens, it is usually immediately after surgery. Sometimes, however, after a few months or even years, it begins to leak from the seam area.

Late leaks are rare, but still dangerous. They may need medication, hospitalization, or additional surgery.

Postoperative hernia

A hernia forms when an organ is pushed through a weak point in tissue or muscle. A hernia can occur after any operation. This is less common in laparoscopic operations. However, a hernia can take months or years to develop. The hernia looks like a lump at the incision site.


Various health problems can arise after surgery. Some problems arise immediately. Others can occur years after surgery. The problems can be mild or severe.

Mental or social problems after gastric sleeve surgery

This surgery can affect your mental health. It can also affect your relationship. These are important things to think about.

Passing dependency

For some, food is an addiction. They can self-medicate by overeating. Since this operation makes it impossible to overeat, patients can develop new addictions. They may include:

  • Alcohol abuse
  • Drug addiction
  • Sex addiction


The divorce rate in the United States is 50%. A 2018 study found that people who had weight-loss surgery had an even higher divorce rate.

It can be difficult for couples to lose weight. The partner may be jealous or is no longer needed. This can increase the likelihood of divorce.

Health professionals recommend that you discuss these concerns with your partner. Family counseling can also help.


Gastric sleeve surgery can cause complications. Patients may have physical symptoms that persist long after surgery. Health and mental health problems can also occur. Before choosing this operation, it is important to discuss all possible complications with your doctor.

Get the word of drug information

Health professionals want surgery to be safe. One way to improve security is to analyze the results over 10 years. Over time, researchers track things like:

  • How patients lose weight
  • How healthy are they?
  • What complications did they have

This operation is relatively new. There is not as much 10-year data as for other operations. This list of complications can grow over time.

You should be happy with your choice to have surgery. Your healthcare professional can explain the risks and complications to you. Your healthcare provider may also suggest other treatments. This will help you make the best decision for you.

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