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Updated: Aug 6, 2026
Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Model in Mice
Published on: February 10, 2023
Single-Anastomosis Duodenoileal Bypass Conversion for Sleeve Gastrectomy: Three-Year Outcomes Comparing 300 cm vs 250
Robert A Casillas1, Eduardo Alvarez1, Adeel Ashfaq1
1Department of Surgery, West Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, USA.
Introduction:
Single-anastomosis duodenoileal bypass (SADI) is an efficacious conversion operation to address suboptimal clinical response after sleeve gastrectomy (SG). Controversy remains regarding optimal length of the common channel for weight loss and potential adverse outcomes. The purpose of this study was to analyze conversion of SG to SADI, comparing 250 cm (SADI-250) to 300 cm (SADI-300) common channel length.
Methods:
Data were collected from n = 63 patients (n = 40 SADI-250; n = 23 SADI-300) that underwent conversion of SG to SADI in a single metabolic and bariatric surgery center of excellence. The primary outcome was percent total weight loss (%TWL). Secondary outcomes were reoperations and nutrition-related complications.
Results:
Three-year follow-up rates for SADI-250 patients were 90% (n = 36) and for SADI-300 were 91% (n = 21). Compared to SADI-300 patients, SADI-250 experienced greater %TWL throughout follow-up (p < .001). SADI-250 patients continued to lose weight through three years; while SADI-300 patients began to regain weight at 12 months. At the end of three years, SADI-250 patients lost 15.1% more weight than SADI-300 patients. There were three reoperations, one for the SADI-300 and two for the SADI-250 and no significant nutritional complications in either group.
Conclusion:
The SADI-250 operation was associated with significantly greater weight loss at three years compared to SADI-300, with no differences in complications between the two operations. Conversion of SG to SADI using a 250 cm common channel led to significant additional weight loss (25.7% TWL at three years).
