Stomach Intestinal Pylorus-Sparing Surgery for Morbid Obesity

The Roux-en-Y duodenal switch (RYDS) is one of the most efficient forms of bariatric surgery. However, diarrhea, malnutrition, ulcers, and internal hernias have hampered its widespread adoption. The stomach intestinal pylorus-sparing (SIPS) procedure was developed to alleviate these sequelae while retaining the same weight loss as the RYDS. In this study, we report our midterm experience with this novel technique.

Retrospective analysis was performed on data from 225 patients who underwent a primary SIPS procedure by 2 surgeons at a single center from October 2013 through December 2016.

Two hundred twenty-five patients were identified for analysis. The mean preoperative body mass index (BMI) was 52.4 ± 9.1 kg/m². Forty-eight patients were beyond 2 years after surgery, with data available for 30 patients (62.5% follow-up). Three patients were lost to follow-up. At 2 years, the patients had an average change in BMI of 26.6 U (kg/m²) with an average of 88.7% of excess weight loss. Three deaths were related to the surgery. The most common short-term complication was a leak (2.2%), whereas the most common long-term complication was diarrhea (2.2%).

In conclusion, SIPS surgery is a safe procedure with favorable weight loss outcomes at 2 years.