Postoperative Bleeding After Sleeve Gastrectomy

Although laparoscopic sleeve gastrectomy (LSG) is considered safe, it carries a risk of complication, as with any surgery. The reported incidence of hemorrhagic complications after LSG is between 1 and 6% postoperatively and can be extraluminal or endoluminal. The LSG is the longest staple line of any bariatric surgical procedure and the most common bleeding site. Laparoscopic staplers have become vital in the use of performing LSG; however, they can be associated with bleeding. Several strategies have been suggested to mitigate the risk of postoperative hemorrhage. Effective management of this complication requires a high index of suspicion, expedient diagnosis, and an appropriate selection of available treatment options. This chapter reviews the currently available surgical and non-surgical management strategies to control postoperative LSG bleeding based on the presenting symptoms and the time of presentation.