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Different intestinal bipartition procedures: early retrospective results from a multicenter Italian experience in 202
Giulia Vitali1, Laura Agostinelli2, Luigi Romeo2
1UOC Chirurgia Generale Ospedale Ceccarini Riccione AUSL Romagna, Riccione, Italy, via Frosinone 7, 47838. giulia.vitali@auslromagna.it.
Background:
Sleeve gastrectomy with intestinal transit bipartition (SG-TB) represents an emerging metabolic bariatric strategy designed to enhance ileal stimulation while preserving physiological nutrient absorption. Different technical variants have been developed, but real world data from multicenter national experiences remain limited. This study aimed to evaluate the preliminary outcomes of intestinal bipartition procedures in Italy.
Methods:
This retrospective multicenter observational study included 202 consecutive patients who underwent Roux-en-Y Transit Bipartition (RYTB), One Anastomosis Transit Bipartition/ Single Anastomosis Sleeve-Ileal bypass (OATB/SASI), or Duodeno-Ileal Transit Bipartition (DITB) between July 2019 and November 2025 across 13 Italian metabolic bariatric centers. Primary outcomes were weight loss expressed as BMI change, percentage of excess weight loss (%EWL), and percentage of total weight loss (%TWL) at 3, 6 and 12 months. Secondary outcomes included weight related disorders resolution, perioperative outcomes, and complications.
Results:
Mean baseline BMI was 45.7 kg/m². At 12 months, BMI decreased to 31.9 kg/m², with a mean %EWL of 65.7% and %TWL of 30.9%. Primary RYTB achieved superior weight loss compared with conversional OATB (%EWL79.7% vs. 64.7%; %TWL 41.7% vs. 29.5%).At 12 months, remission rates were 58.5% for hypertension, 34.2% for type 2 diabetes (50% improved), 76.1% for OSAS, and 75% for dyslipidemia. Early complications occurred in 9.9% of patients, with major complications (Clavien-Dindo ≥IIIb) in 1.5%. Readmission rate was 2.5%.
Conclusions:
Intestinal bipartition procedures demonstrated effective weight loss, significant metabolic improvement, and a favorable safety profile in a real world multicenter setting, in our early (12 months) results. Primary procedures achieved more consistent weight loss, although conversional surgery provided clinically meaningful outcomes. Standardization of technical parameters, particularly common channel length, may further optimize results.
