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Obesity Surgery
Published in: Obesity Surgery 10/2019

01-10-2019 | Sleeve Gastrectomy | Original Contributions

A Multi-institutional Study on the Mid-Term Outcomes of Single Anastomosis Duodeno-Ileal Bypass as a Surgical Revision Option After Sleeve Gastrectomy

Authors: Hinali Zaveri, Amit Surve, Daniel Cottam, Peter C. Ng, Paul Enochs, Helmuth Billy, Walter Medlin, Christina Richards, LeGrand Belnap, Lindsey S. Sharp, Dustin M. Bermudez, Ryan Fairley, Tricia A. Burns, Krista Herrell, Jaime Bull, Sophia E. Menozzi, John Ambrose Student

Published in: Obesity Surgery | Issue 10/2019

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Abstract

Introduction

Recently, a single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has become increasingly popular for patients with BMI > 50 as a primary or staged surgery. Staging allows surgeons to do the sleeve gastrectomy (SG) first with the conversion only happening when a failure or technical challenge is identified.

Purpose

We present the mid-term outcomes of SADI bypass surgery after SG.

Method

A retrospective analysis was performed on a prospective database from four institutions. Ninety-six patients were identified from 2013 to 2018. Patients were divided into two groups: one had two-stage SADI because of insufficient weight loss, the second had planned two-stage SADI because of super obesity (BMI > 50 kg/m2). Incidence of complications was divided into < 30 days and > 30 days.

Result

Of 96 patients, 3 patients were completely lost to follow-up. The mean age was 44.8 ± 11.3 years. There were no deaths or conversion to open surgery. The postoperative early complication and late complication rate was 5.3% and 6.4% respectively. At 24 months, group 2 had higher %weight loss (WL) and change in BMI units compared to group 1 with statistically significant difference. The average WL and change in BMI for entire patient’s population at 24 months after 2nd stage SADI was 20.5% and 9.4 units respectively. The remission rate for DM was 93.7% with or without the use of medication.

Conclusion

The two-stage approach to SADI-S appears technically simpler than a single compromised operation. However, this approach needs more patients to understand its limitations.
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Metadata
Title
A Multi-institutional Study on the Mid-Term Outcomes of Single Anastomosis Duodeno-Ileal Bypass as a Surgical Revision Option After Sleeve Gastrectomy
Authors
Hinali Zaveri
Amit Surve
Daniel Cottam
Peter C. Ng
Paul Enochs
Helmuth Billy
Walter Medlin
Christina Richards
LeGrand Belnap
Lindsey S. Sharp
Dustin M. Bermudez
Ryan Fairley
Tricia A. Burns
Krista Herrell
Jaime Bull
Sophia E. Menozzi
John Ambrose Student
Publication date
01-10-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-03917-1

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