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Major complications include bleeding from the staple line (1%) requiring transfusion or possible reoperation, staple line leaks (1 -2%), and blood clot to the lungs. Other problems include the sleeve being too tight because of scarring or the development of a partial twist. Injury to other abdominal organs such as the spleen, or intestine is possible although very uncommon. The mortality rate after vertical sleeve gastrectomy has been reported in the range of 2/1000. Causes of death include blood clot to the lungs, infection following leaks, pneumonia, cardiac irregularities or heart attack, stroke, and other rare events.

Long term problems can include esophageal reflux, gastritis, and rarely bowel obstruction due to adhesions (scars inside of the abdomen). Vitamin deficiency can occur if patients do not eat a healthy diet and do not take certain vitamin supplements. The supplements include multivitamins, B12, and in some cases iron. Depending on a person’s metabolism, other vitamins may be necessary. Vitamin levels can be checked with a blood test, so long term deficiencies can definitely be prevented.
 

Esophageal reflux

One of the problems that some patients face after sleeve gastrectomy is esophageal reflux. Reflux causes heartburn and esophagitis. It may occur soon after sleeve gastrectomy or may appear after several years. There are probably several causes for reflux, and the problem has not been extensively researched. The sleeve itself can be obstructive. It is a long narrow tube, and if too tight, may not function well. Second, a patient may develop problems with motility of the esophagus or with the sphincter muscle between the esophagus and stomach. And third, some patients may develop a hiatus hernia. A hiatus hernia is a widening of the diaphragm at the point where the esophagus passes from the chest into the abdomen. When a hiatus hernia develops, the stomach slips into the chest and the sphincter at the end of the esophagus is less effective. With a weakened sphincter muscle reflux occurs.

Complications From Sleeve Gastrectomy

The most significant complications associated with this bariatric surgery are leakage, sleeve dilation and a number of other general problems. Let's take a look at them.

Leakage
As mentioned earlier, a portion of the stomach is removed and the edges of the stomach are stapled or fixed together during the sleeve gastrectomy surgery. Sometimes, the staple line may show leakages and hemorrhages due to intra-abdominal pressure,. However, such sleeve gastrectomy complications can be easily treated by conducting a second procedure that strengthens the staple line of the sleeve.

Gastroesophageal Reflux
Gastroesophageal reflux refers to the regurgitation of gastric content into the esophagus. When the acids present in the stomach flow towards the esophagus, it is likely to cause irritation of the esophagus. This leads to heartburn, thereby causing a burning sensation in the chest. This is one of the most common complications of laparoscopic sleeve gastrectomy, that is probably a result of the change in the shape of the stomach.

Gastric Fistula
The irregular, hollow and tube-like passage connecting the stomach to the wall of the abdomen is called gastric fistula. It is created, either pathologically or by surgery. In some 3-5% of sleeve gastrectomy cases, it comes as a post-operative result. This is one of the possible complications resulting from sleeve gastrectomy.

Narrowing of Stoma
Sleeve gastrectomy procedure may cause narrowing of stoma, which is an opening between the stomach and intestine. Another surgery may be required to fix this condition. In some cases, it can be corrected with the help of an instrument. The stoma can be expanded with the help of a dilating tube.

Hiatal Hernia
If the vertical sleeve of the stomach is too tight, it could create problems associated with the sphincter muscle that is located between the esophagus (food pipe) and the stomach. Hiatal hernia is one of the common complications from sleeve gastrectomy. Hiatus refers to an opening in the diaphragm through which the esophagus passes. If this opening widens, the stomach may protrude from the opening into the chest.

Malabsorption of Vitamins and Minerals
One long-term complication of sleeve gastrectomy is malabsorption of certain vitamins and minerals. This leads to deficiency of particular vitamins and minerals, which may further cause a number of other disorders. Deficiency of iron results in anemia while deficiency of vitamin B12 can cause neurological disorders. Changes in absorption of calcium, phosphates and oxalates can lead to the formation of kidney stones. Similarly, deficiency of calcium, phosphates and vitamin D can give rise to various bone diseases.

Other Possible Gastrectomy Complications
Vertical sleeve gastrectomy may also give rise to some common complications associated with other bariatric surgeries. The most prominent among those is microbial infection at the wound site. Another problem topping the list is deep vein thrombosis (DVT) or formation of blood clot in the leg. There is yet another complication that is sometimes seen after sleeve gastrectomy. At times, dilation of the vertical sleeve could lead to an increase in the food intake capacity of the patient.

In addition to all the problems listed above, sleeve gastrectomy complications may include hair loss, hair thinning, mood swings, dry skin and a general feeling of weakness. Any issue with sleeve gastrectomy needs a high level of medical attention and care. Do not try to be your own doctor. It is best to seek medical help. Strictly follow the advice and comply with the guidelines given by your surgeon.

Here's a forum with posts from people having VSG complications:
http://www.verticalsleevetalk.com/forum/48-gastric-sleeve-su rgery-vsg-complications-support-group/

and some abstracts:
http://www.thinnertimes.com/weight-loss-surgery/vertical-sle eve-gastrectomy/vertical-sleeve-gastrectomy-risks-and-compli cations.html