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. 2023 Nov;37(11):8682-8689.
doi: 10.1007/s00464-023-10305-5. Epub 2023 Jul 27.

Primary single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) versus sleeve gastrectomy to SADI conversions: a comparison study of prevalence and safety

Juan S Barajas-Gamboa  1 , Soon Moon  2 , Gustavo Romero-Velez  2 , Andrew T Strong  2 , Matthew Allemang  2   3 , Salvador Navarrete  2 , Ricard Corcelles  2   3 , John Rodriguez  1   3 , Matthew Kroh  2   3 , Jerry T Dang  4   5
Affiliations

Primary single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) versus sleeve gastrectomy to SADI conversions: a comparison study of prevalence and safety

Juan S Barajas-Gamboa et al. Surg Endosc. 2023 Nov.

Abstract

Background: Conversion from sleeve gastrectomy (SG) to single anastomosis duodeno-ileal bypass (SADI) is becoming increasingly common, but data regarding safety is of these conversions is scarce. As such, the objective of this study was to compare the 30-day rate of serious complications and mortality of primary SADI (p-SADI-S) with SG to SADI (SG-SADI) conversions.

Methods: This retrospective cohort study analyzed the MBSAQIP database. Patients undergoing p-SADI-S and SG-SADI were included. Data collection was limited to 2020 and 2021. A multivariable logistic regression analysis was performed between groups to determine if SG-SADI was an independent predictor of 30-day serious complications or mortality.

Results: A total of 783 patients were included in this study, 488 (62.3%) underwent p-SADI-S and 295 (37.6%) underwent SG-SADI. The mean body mass index (BMI) at the time of surgery was lower in the SG-SADI cohort (45.1 vs 51.4 kg/m2, p < 0.001). Indications for revision in the SG-SADI cohort included weight recurrence (50.8%), inadequate weight loss (41.0%), other (3.0%), GERD (2.7%), and persistent comorbidities (2.5%). SG-SADI had longer operative times (156.7 vs 142.1 min, p < 0.001) and was not associated with a higher rate of serious complications (5.7 vs 6.9%, p = 0.508) compared to p-SADI-S. p-SADI-S was associated with a higher rate of pneumonia (1.2 vs 0.0%, p < 0.001), and SG-SADI was not correlated with higher rates of reoperation (3.0 vs 3.2%, p = 0.861), readmission (5.4 vs 5.5%, p = 0.948) and death (0.0 vs 0.2%, p = 0.437). On multivariable analysis, SG-SADI was not independently predictive of serious complications (OR 0.81, 95% CI 0.43 to 1.52, p = 0.514) when adjusting for age, sex, BMI, comorbidities, and operative time.

Conclusions: The prevalence of SG-SADI is high, representing 37.6% of SADI-S procedures. Conversion from sleeve to SADI, is safe, and as opposed to other studies of revisional bariatric surgery, has similar 30-day complication rates to primary SADI-S.

Keywords: Bariatric surgery; Inadequate weight loss; Revisional surgery; SADI-S; Sleeve gastrectomy; Weight regain.

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References

    1. Admella V, Lazzara C, Sobrino L, Acrich E, Biondo S, Pujol-Gebellí J, Osorio J (2023) Patient-reported outcomes and quality of life after single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): a cross-sectional study with 283 patients from a single institution. Obes Surg. https://doi.org/10.1007/s11695-023-06554-x - DOI - PubMed - PMC
    1. Tat C, Del Gobbo GD, Klingler M, Corcelles R (2020) How I do it: robotic single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADIS). J Gastrointest Surg 24(12):2893–2895. https://doi.org/10.1007/s11605-020-04789-y - DOI - PubMed
    1. Marincola G, Velluti V, Voloudakis N, Gallucci P, Ciccoritti L, Greco F, Sessa L, Salvi G, Iaconelli A, Aquilanti B, Guidone C, Capristo E, Mingrone G, Pennestrì F, Raffaelli M (2023) Medium-term nutritional and metabolic outcome of single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). Nutrients 15(3):742. https://doi.org/10.3390/nu15030742 - DOI - PubMed - PMC
    1. Rao R, Mehta M, Sheth DR, Hogan G (2023) Four-year nutritional outcomes in single-anastomosis duodeno-ileal bypass with sleeve gastrectomy patients: an Australian experience. Obes Surg 33(3):750–760. https://doi.org/10.1007/s11695-023-06461-1 - DOI - PubMed - PMC
    1. Admella V, Osorio J, Sorribas M, Sobrino L, Casajoana A, Pujol-Gebellí J (2021) Direct and two-step single anastomosis duodenal switch (SADI-S): unicentric comparative analysis of 232 cases. Cir Esp 99(7):514–520. https://doi.org/10.1016/j.cireng.2021.06.017 - DOI - PubMed

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