What is Gastric Leak, and how likely is it after my Gastric Sleeve Surgery?

Sep 15, 2017 — by Daniel Huacuz, MD

Gastric sleeve surgery has fast become one of the most popular weight loss procedures in the world for people at varying stages of obesity. It is considered a relatively simple procedure, with operations taking an hour or two at the most. It not only restricts the size of the stomach, but also the appetite through a reduction in the ghrelin hormone, and it has a reportedly low incidence of mortality and related complications associated with it. The surgery is cheaper, safer, and less invasive than comparably bypass and duodenal switch procedures and can often be converted into either of the above with ease.

However, it is not without its dangers. Staple line gastric leaks and bleeding are one of the most feared complications arising from this surgery, posing the possibility of prolonged hospital stay, costly revisions and even death. So what is gastric leak and is it possible to get it after your gastric sleeve surgery?

How Gastric Leak Occurs

Sleeve Gastrectomy usually involves several small incisions about a quarter inch to half an inch wide, made across the abdomen. A tiny camera is then inserted through these cuts to guide surgeons through the process of removing about a three quarters of your original stomach and reshaping the remaining portion into a sleeve-like shape. The cuts are then stapled together using a biodegradable, watertight glue that dissolves over a 6-8 week period as your body’s natural healing mechanisms take over to close over the scars.

Gastric leaks usually occur anywhere from within 3 to 30 days of a surgery. They usually occur when staples come apart, or the skin heals improperly over the staples in rare cases they occur due to technical errors during the surgical process. This leakage results in liquid flowing from the stomach into the still healing scar tissue, which can cause serious infection. This complication occurs in around 1 to 3% of gastric leak patients.

Symptoms of Gastric Leak

Patients, who are reported to suffer from gastric leaks, usually experience unusual or elevated heart rate, the sudden onset of high fever, pain in their left shoulder, chest pains with increasing pain each subsequent day left untreated. Patients are recommended to call their surgeon’s office immediately if they experience any of these symptoms.

How Gastric Leak is treated

Often the first step in determining a possible leak is a CT scan. Usually this will show some air bubbles outside of the area of the staple line, which show that material is leaking out of the patient’s gastric sleeve. The first step attempted after a positive identification is usually to insert a drainage tube where the leak is suspected. This allows the fluid to drain out until the body can heal over the leak. In addition a course of antibiotic and nutritional aids is administered to the patient via IV, in order to fight any infection.

In worst case scenarios where leaks are persistent, which is often the case with early sufferers. Revisions may be necessary, these can take the form of another gastric sleeve surgery to correct earlier issues, or the surgery may be extended into a more complete procedure such as duodenal switch or gastric bypass.


While gastric leaks are uncommon, they do pose a real threat to a select few gastric sleeve patients after surgery. It’s important that you pay attention to your body, and follow your surgeon’s recommendations on diet, lifestyle and medicinal courses. These leaks are very treatable if caught early, but can pose a far greater threat if left untreated.

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