Skip to main content
Top
Published in: Obesity Surgery 12/2018

01-12-2018 | Original Contributions

Matched Short-Term Results of SADI Versus GBP After Sleeve Gastrectomy

Authors: C. M. M. Ceha, M. R. van Wezenbeek, D. P. A. Versteegden, J. F. Smulders, S. W. Nienhuijs

Published in: Obesity Surgery | Issue 12/2018

Login to get access

Abstract

Background

The gastric bypass (GBP) is the most popular revisional technique after sleeve gastrectomy (SG). However, the results after revision are not always satisfactory in terms of additional weight loss and complications. The single anastomosis duodenoileal bypass (SADI) could be a valuable alternative.

Objective

This study is a retrospective matched-control study reviewing short-term results in terms of weight loss and comorbidities reduction of both SADI and GBP as a revisional procedure after primary sleeve gastrectomy. Complications and vitamin deficiencies will be evaluated as well.

Methods

Patients with a SADI procedure after a primary sleeve gastrectomy (SG) with a minimum follow-up of 1 year were included. Their results were retrospectively reviewed and matched with a cohort of GBP patient on age, BMI, and gender. Comparison was on comorbidities, weight loss, complications, and blood markers.

Results

A total of 64 patients were included, 32 SADI procedures and 32 matched gastric bypasses with no significant differences on baseline. No differences were found in terms of (additional) total weight loss. The operating time of the SADI was significantly longer (p = 0.007). No clinically relevant differences were found concerning comorbidities or blood markers. In the SADI group, more defecation problems were reported and fewer vitamin deficiencies were encountered.

Conclusion

Based on a small group and short-term results, the SADI could be regarded as a safe alternative to a GBP following SG with a similar amount of additional weight loss and fewer post-operative early complications. Longer follow-up and larger studies are needed to determine its full potential.
Literature
2.
go back to reference Major P, Matlok M, Pedziwiatr M, et al. Quality of life after bariatric surgery. Obes Surg. 2015;25(9):1703–10.CrossRef Major P, Matlok M, Pedziwiatr M, et al. Quality of life after bariatric surgery. Obes Surg. 2015;25(9):1703–10.CrossRef
3.
go back to reference Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.CrossRef Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.CrossRef
4.
go back to reference Dapri G, Cadiere GB, Himpens J. Superobese and super-superobese patients: 2-step laparoscopic duodenal switch. Surg Obes Relat Dis. 2011;7(6):703–8.CrossRef Dapri G, Cadiere GB, Himpens J. Superobese and super-superobese patients: 2-step laparoscopic duodenal switch. Surg Obes Relat Dis. 2011;7(6):703–8.CrossRef
5.
go back to reference Sovik TT, Taha O, Aasheim ET, et al. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Br J Surg. 2010;97(2):160–6.CrossRef Sovik TT, Taha O, Aasheim ET, et al. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Br J Surg. 2010;97(2):160–6.CrossRef
6.
go back to reference Sanchez-Pernaute A, Herrera MA, Perez-Aguirre ME, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20(12):1720–6.CrossRef Sanchez-Pernaute A, Herrera MA, Perez-Aguirre ME, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20(12):1720–6.CrossRef
7.
go back to reference Sanchez-Pernaute A, Rubio MA, Perez Aguirre E, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis. 2013;9(5):731–5.CrossRef Sanchez-Pernaute A, Rubio MA, Perez Aguirre E, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis. 2013;9(5):731–5.CrossRef
8.
go back to reference Corcelles R, Boules M, Froylich D, et al. Total weight loss as the outcome measure of choice after roux-en-Y gastric bypass. Obes Surg. 2016;26(8):1794–8.CrossRef Corcelles R, Boules M, Froylich D, et al. Total weight loss as the outcome measure of choice after roux-en-Y gastric bypass. Obes Surg. 2016;26(8):1794–8.CrossRef
9.
go back to reference Sczepaniak JP, Owens ML, Shukla H, et al. Comparability of weight loss reporting after gastric bypass and sleeve gastrectomy using BOLD data 2008-2011. Obes Surg. 2015;25(5):788–95.CrossRef Sczepaniak JP, Owens ML, Shukla H, et al. Comparability of weight loss reporting after gastric bypass and sleeve gastrectomy using BOLD data 2008-2011. Obes Surg. 2015;25(5):788–95.CrossRef
10.
go back to reference Shikora SA, Kim JJ, Tarnoff ME, et al. Laparoscopic roux-en-Y gastric bypass: results and learning curve of a high-volume academic program. Arch Surg. 2005;140(4):362–7.CrossRef Shikora SA, Kim JJ, Tarnoff ME, et al. Laparoscopic roux-en-Y gastric bypass: results and learning curve of a high-volume academic program. Arch Surg. 2005;140(4):362–7.CrossRef
11.
go back to reference Carmeli I, Golomb I, Sadot E, et al. Laparoscopic conversion of sleeve gastrectomy to a biliopancreatic diversion with duodenal switch or a roux-en-Y gastric bypass due to weight loss failure: our algorithm. Surg Obes Relat Dis. 2015;11(1):79–85.CrossRef Carmeli I, Golomb I, Sadot E, et al. Laparoscopic conversion of sleeve gastrectomy to a biliopancreatic diversion with duodenal switch or a roux-en-Y gastric bypass due to weight loss failure: our algorithm. Surg Obes Relat Dis. 2015;11(1):79–85.CrossRef
12.
go back to reference Homan J, Betzel B, Aarts EO, van Laarhoven KJ, Janssen IM, Berends FJ. Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis. 2015;11(4):771–7.CrossRef Homan J, Betzel B, Aarts EO, van Laarhoven KJ, Janssen IM, Berends FJ. Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis. 2015;11(4):771–7.CrossRef
13.
go back to reference Sanchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–5.CrossRef Sanchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–5.CrossRef
14.
go back to reference Gibbons C, Caudwell P, Finlayson G, et al. Comparison of postprandial profiles of ghrelin, active GLP-1, and total PYY to meals varying in fat and carbohydrate and their association with hunger and the phases of satiety. J Clin Endocrinol Metab. 2013;98(5):E847–55.CrossRef Gibbons C, Caudwell P, Finlayson G, et al. Comparison of postprandial profiles of ghrelin, active GLP-1, and total PYY to meals varying in fat and carbohydrate and their association with hunger and the phases of satiety. J Clin Endocrinol Metab. 2013;98(5):E847–55.CrossRef
15.
go back to reference Webb DL, Abrahamsson N, Sundbom M, et al. Bariatric surgery - time to replace with GLP-1? Scand J Gastroenterol. 2017;52(6–7):635–40.CrossRef Webb DL, Abrahamsson N, Sundbom M, et al. Bariatric surgery - time to replace with GLP-1? Scand J Gastroenterol. 2017;52(6–7):635–40.CrossRef
16.
go back to reference Gebelli JP, Gordejuela AG, Ramos AC, et al. Sadi-S with Right Gastric Artery Ligation: Technical Systematization and Early Results. Arq Bras Cir Dig. 2016;29Suppl 1(Suppl 1):85–90.CrossRef Gebelli JP, Gordejuela AG, Ramos AC, et al. Sadi-S with Right Gastric Artery Ligation: Technical Systematization and Early Results. Arq Bras Cir Dig. 2016;29Suppl 1(Suppl 1):85–90.CrossRef
17.
go back to reference Madan AK, Orth WS, Tichansky DS, et al. Vitamin and trace mineral levels after laparoscopic gastric bypass. Obes Surg. 2006;16(5):603–6.CrossRef Madan AK, Orth WS, Tichansky DS, et al. Vitamin and trace mineral levels after laparoscopic gastric bypass. Obes Surg. 2006;16(5):603–6.CrossRef
18.
go back to reference Kjellmo CA, Karlsson H, Nestvold TK, Ljunggren S, Cederbrant K, Marcusson-Stahl M, et al. Bariatric surgery improves lipoprotein profile in morbidly obese patients by reducing LDL cholesterol, apoB, and SAA/PON1 ratio, increasing HDL cholesterol, but has no effect on cholesterol efflux capacity. J Clin Lipidol 2017. Kjellmo CA, Karlsson H, Nestvold TK, Ljunggren S, Cederbrant K, Marcusson-Stahl M, et al. Bariatric surgery improves lipoprotein profile in morbidly obese patients by reducing LDL cholesterol, apoB, and SAA/PON1 ratio, increasing HDL cholesterol, but has no effect on cholesterol efflux capacity. J Clin Lipidol 2017.
19.
go back to reference Greenstein AJ, O'Rourke RW. Abdominal pain after gastric bypass: suspects and solutions. Am J Surg. 2011;201(6):819–27.CrossRef Greenstein AJ, O'Rourke RW. Abdominal pain after gastric bypass: suspects and solutions. Am J Surg. 2011;201(6):819–27.CrossRef
20.
go back to reference Johnson JM, Maher JW, DeMaria EJ, et al. The long-term effects of gastric bypass on vitamin D metabolism. Ann Surg. 2006;243(5):701–4. discussion 4-5CrossRef Johnson JM, Maher JW, DeMaria EJ, et al. The long-term effects of gastric bypass on vitamin D metabolism. Ann Surg. 2006;243(5):701–4. discussion 4-5CrossRef
Metadata
Title
Matched Short-Term Results of SADI Versus GBP After Sleeve Gastrectomy
Authors
C. M. M. Ceha
M. R. van Wezenbeek
D. P. A. Versteegden
J. F. Smulders
S. W. Nienhuijs
Publication date
01-12-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3415-5

Other articles of this Issue 12/2018

Obesity Surgery 12/2018 Go to the issue