Single-Anastomosis Duodenoileal Bypass Conversion for Sleeve Gastrectomy: Three-Year Outcomes Comparing 300 cm vs 250...

Area of Science:

• Bariatric surgery
• Metabolic surgery
• Gastrointestinal surgery

Background:

• Single-anastomosis duodenoileal bypass (SADI) is effective for patients with suboptimal response post-sleeve gastrectomy (SG).
• Optimal common channel length for SADI conversion remains debated, impacting weight loss and adverse outcomes.
• This study compares 250 cm (SADI-250) versus 300 cm (SADI-300) common channel lengths for SG to SADI conversion.

Purpose of the Study:

• To analyze the efficacy of SG to SADI conversion comparing 250 cm versus 300 cm common channel lengths.
• To evaluate weight loss and complication rates between SADI-250 and SADI-300.
• To determine the optimal common channel length for maximizing weight loss after SG.

Main Methods:

• Retrospective analysis of 63 patients undergoing SG to SADI conversion.
• Patients were divided into two groups: SADI-250 (n=40) and SADI-300 (n=23).
• Primary outcome: percent total weight loss (%TWL); Secondary outcomes: reoperations and nutritional complications.

Main Results:

• Three-year follow-up rates were high (90% for SADI-250, 91% for SADI-300).
• SADI-250 achieved significantly greater %TWL compared to SADI-300 (p < .001).
• SADI-250 patients showed sustained weight loss, while SADI-300 patients experienced weight regain starting at 12 months; 15.1% greater weight loss in SADI-250 at 3 years. Reoperations and nutritional complications were similar between groups.

Conclusions:

• SADI with a 250 cm common channel leads to significantly greater weight loss at three years compared to a 300 cm channel.
• The SADI-250 operation is a safe and effective option for SG conversion, achieving 25.7% TWL at three years.
• A 250 cm common channel is recommended for maximizing weight loss following SG to SADI conversion.