十二指肠憩室为常见消化道病变，其并发症并不常见，腹腔镜下袖状胃切除术后并发十二指肠憩室穿孔的情况罕见，且诊治难度较高。本文报告1例天津医科大学朱宪彝纪念医院收治的相关病例并取得较好效果。腹腔镜下袖状胃切除术后并发十二指肠憩室穿孔可能与术后胃排空加快、饮食因素导致的十二指肠内压力升高相关。此类患者的治疗需根据穿孔部位、感染范围及全身状况选择方案，本例采用穿刺引流术取得良好效果。鉴于十二指肠憩室可能影响手术实施及术后预后，建议袖状胃术前常规行胃十二指肠镜及腹部CT检查，评估憩室情况以优化手术决策。对于合并十二指肠憩室需要行代谢减重手术患者，胃旁路手术是否是一个更优的选择仍是一个值得探讨的问题。

Duodenal diverticulum is a common gastrointestinal lesion, but its complications are uncommon. Perforation of duodenal diverticulum following laparoscopic sleeve gastrectomy (LSG) is extremely rare and poses significant diagnostic and therapeutic challenges. This article reports a relevant case treated at Chu Hsien-I Memorial Hospital of Tianjin Medical University with favorable outcomes. The occurrence of duodenal diverticulum perforation after LSG may be associated with increased intraduodenal pressure caused by accelerated gastric emptying postoperatively and dietary factors. The treatment of such patients should be individualized based on the location of perforation, extent of infection, and general condition of the patient; in this case, percutaneous puncture and drainage achieved excellent results. Given that duodenal diverticulum may affect surgical implementation and postoperative prognosis, it is recommended that routine gastroduodenoscopy and abdominal computed tomography (CT) be performed before LSG to evaluate the diverticulum and optimize surgical decision-making. Whether gastric bypass surgery is a superior option for obese patients with concurrent duodenal diverticulum who require metabolic bariatric surgery remains a question worthy of further exploration.