Table 3 Complications of laparoscopic sleeve gastrectomy

Intraoperative (n = 3)

Liver contusion (n = 1)

Splenic tear (n = 2): a serrated low-density area in the spleen

Early postoperative (n = 48)

• Leakage (n = 18): (23.1%); within 1–10 days. (Figs. 8 and 9)

• The most common site of leak was the proximal 1/3 of the sleeve just below the esophagogastric junction, followed by middle then lower thirds

• Pneumoperitoneum

• Free fluid

Laparoscopic re-exploration and surgical closure

Perigastric collection and hematoma (n = 26) (33%) within 3–10 days (Fig. 7)

• Acute hematoma: hyperdense collection

• Hemoperitoneum (n = 5)

• Extravasation of IV contrast if there is active bleeding from staple lines or suture lines (n = 2)

Conservative (n = 9) laparoscopic—re-exploration and surgical drainage in the presence of hemodynamic instability (n = 3)

Gastropancreatic abscess (n = 1) located in the left subphrenic area (Fig. 11)

CT-guided percutaneous drainage with appropriate antibiotic coverage

Gastrobronchial fistula (n = 1)

The site of the fistulous tract was clearly visualized by CT

failed to heal after endoscopic insertion of a stent

Rectus sheath hematoma: (n = 2)

Late postoperative (n = 27)

Vascular thrombosis: PV, SMV, and SV (n = 10) (13%) within 6 months to 2 years postoperatively (Fig. 10)

Medical treatment.

Gastric stricture (n = 1) (Fig. 12)

Focal strictures respond to endoscopic dilation, but longer segments of narrowing necessitate surgical revision or resection of the pouch

Dilatation of the gastric pouch (n = 8) (10%) and weight gain (Fig. 13)

Surgical revision of the pouch

Incisional hernia(n = 1): eventration of bowel loops and mesenteric fat

Hiatus hernia (n = 4)

Gastritis(n = 1)

S.C. seroma (n = 1)

Port site hernia (n = 1)