Gastric Sleeve Complications & Side Effects - The 5 Most Common Issues - Bariatric Surgery Source

Gastric Sleeve Complications & Side Effects - The 5 Most Common Issues

Reviewed by:  

John Rabkin, MD

Last Updated:  


Potential gastric sleeve complications and side effects include:

  • Staple line leaks
  • Bleeding
  • Stenosis/strictures
  • Digestion issues
  • Sagging skin from rapid weight loss

Fortunately, serious complications are relatively rare and not usually life threatening; Gastric sleeve surgery has a survival rate of 99.8%. There are also several ways to reduce the risk of complications.

Read and click the sections below for more information.

01General Safety
  • Very safe: 0.19% mortality rate
  • Click here to compare to other common procedures

Gastric Sleeve Complications

Compare the 0.19% mortality rate of the gastric sleeve to other well-known procedures:

  • Gallbladder removal: 0.15% mortality rate (1)
  • Hip replacement: 0.29% mortality rate (2)
  • Cesarean section (“C-Section”): 0.40% mortality rate (3)

In other words, gastric sleeve is about as risky as gallbladder surgery and a lot less risky than a hip replacement or a C-section.

Typical gastric sleeve results include:

  • 1-year weight loss: 70% of excess weight, on average
  • 5-year weight loss: 55% of excess weight, on average, after weight regain
  • Complete resolution or significant improvement for at least 15 obesity-related health conditions, including diabetes, hypertension, and sleep apnea

See our Gastric Sleeve Results section for more information about weight loss and health benefits to expect.

Studies: Gastric Sleeve Complication & Mortality Rates

02Serious Complications
  • Relatively rare & not usually life-threatening
  • Staple line leaks - 2% of patients
  • Bleeding - 1% of patients
  • Stenosis/strictures - 1% of patients

Gastric Sleeve Complications

The most common serious complications include (from most common to least common)…

  1. Staple line leaks – 2.1% of patients on average (between 1.09% and 4.66%, depending on the study) experience staple line leaks (4) (5).
  2. Bleeding – 1.2% of patients (6).
  3. Stenosis/Strictures – 0.6% of patients (7).

Regarding gastric sleeve staple line leaks, there appears to be ways to reduce the risk, depending on your surgeon’s materials and technique.

For example, a review of many gastric sleeve staple line leak studies found that leaks after a traditional gastric sleeve procedure occur less often (1.09%) when using an absorbable polymer membrane (APM) to reinforce the staple line.

Click here to contact a top surgeon to discuss options for minimizing the risk of gastric sleeve complications.


03Side Effects
  • Digestion issues are possible
  • Sagging skin from rapid weight loss

Gastric Sleeve Complications

Digestion Issues

Gastroesophageal reflux disease (GERD) is a relatively common short-term issue for new gastric sleeve patients. In the first year after surgery, about 20% of patients experience it, but that rate drops to around 3% after 3 years (8).

Other potential gastric sleeve side effects include (9) (10):

  • Gallstones
  • Indigestion (Dyspepsia)
  • Intolerance to certain foods
  • Nausea and vomiting
  • Vitamin and mineral deficiency

Sagging Skin

Most gastric sleeve patients lose weight very quickly after surgery – as much as 70% of excess weight in the first year. Since most patients’ skin has been stretched out for so long, it is unable to “bounce back.” The result is sagging skin.

In addition to being embarrassing, sagging skin can cause health, hygiene, and lifestyle issues such as:

  • Difficulty getting dressed
  • Difficulty exercising, which may impact long-term weight maintenance and health
  • Skin fold rashes or breakdown of skin
  • Skin fold infections

Body-contouring undergarments may be enough to solve the issue. For more serious cases, plastic surgery is needed to remove the extra skin.

See our Plastic Surgery After Weight Loss page for more information.

04How to Avoid Complications
  • Educate yourself, family, & friends about what to expect
  • Follow surgeon's advice
  • Adhere to pre-surgery diet regimen
  • Get sleep apnea syndrome test
  • Adhere to post-op diet & exercise regimen

Gastric Sleeve Complications

Many potential gastric sleeve complications can be completely avoided with the right behavior, including:

  • Pick a good surgeon and follow their advice to the letter
  • Educate yourself ahead of time about what to expect
  • Educate your family and friends
  • Lose as much weight as possible prior to surgery
  • Eat the right gastric sleeve diet in the months leading up to surgery
  • Get tested for sleep apnea syndrome several weeks before surgery (and address the issue if it exists before moving forward)
  • Plan for at least 2 weeks of recovery time
  • Exercise right away after surgery, but take it easy at first.
  • Take action to reduce the risk of a blood clot, including the use of:
    1. Compression stockings
    2. Pneumatic compression devices
    3. Blood thinners after surgery
  • Have an effective support system of friends, family, and weight loss surgery support groups

See our Bariatric Surgery Complications page for more information about each of these points.

05Help & Support
  • Patient experiences
  • Ask the expert

Gastric Sleeve Complications

We would love to hear your experiences with gastric sleeve complications. Your insights are invaluable to making sure other people have the tools to meet their goals.

We would also be happy to answer any questions you may have about gastric sleeve complications.

Please use the form below to share your experience or ask a question.

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* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More