Laparoscopic Single Anastomosis Duodeno-ileal Bypass-Sleeve Gastrectomy versus Laparoscopic Sleeve Gastrectomy

Background: In an attempt to simplify the effective BPD-DS procedure- the same way Rutledge simplified RYGB by doing one loop end-to-side anastomosis – and to preserve its principles, the single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was first described in 2007by Sánchez-Pernaute and Torres as they did Sleeve gastrectomy followed by 1-loop duodenoileostomy, with 250 cm between anastomosis and ileocecal valve. Anastomosis performed in antecolic and isoperistaltic manner.

Purpose to assess weight loss between the two procedures, in addition to OR time and LOS.

Patients and Methods: The interventions were led at Beni-suef University Hospital between January 2018 and December 2019, after the patients fitted both the inclusions and exclusions criteria. This study consisted of 36 patients which were randomized into 2 groups. Group (A): 18 patients assigned for Single Anastomosis Duodeno-ileal bypass – Sleeve Gastrectomy [SADI-S]. Group (B): 18 patients assigned for Sleeve Gastrectomy.

Results: The SADI-S group achieved mean excess weight loss of 65.8% ±5.2 at 6 months and 93% ± 9.7at 12 months postoperative and mean percentage of total weight loss of 31.3%± 4.3at 6 months and 44.3% ± 6.4 at 12 months postoperative. On the other hand, Sleeve gastrectomy group reached mean excess weight loss of 43.7% ±8.3 at 6 months and 67.2% ± 6.3 at 12 months postoperative and mean percentage of total weight loss of 20.3%± 4 at 6 months and 32.7% ± 6.8 at 12 months postoperative. There is a statistically significant difference between both groups at all follow up visits (p-value < 0.001).

Conclusion: SADI-S/OADS is more effective than LSG regarding weight loss.SADI-S/OADS took more operative time and longer hospital stay than LSG.