Laparoscopic Single Anastomosis Duodeno-ileal Bypass-Sleeve Gastrectomy versus Laparoscopic Sleeve Gastrectomy Regarding Hypoalbuminaemia and Lower Limb Edema

Background: In a trial to modify the effective biliopancreatic diversion BPD-DS operation- the same way Rutledge modified RYGB by creating one loop end-to-side anastomosis – and to preserve its principles, the single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was first introduced in 2007 by 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 manne

Purpose: It is to assess postoperative hypoalbuminaemia and lower limb edema in the two procedures.

Patients and Methods: The interventions were led at Beni-suef University Hospital between January 2018 and December2019, 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: Mean albumin level at 12 months after surgery was 3.1 g/dl ± 0.35 for SADI-S patients and was 3.83 g/dl ± 0.34 for sleeve gastrectomy patients. There is a statistically significant difference between both groups.

Conclusion: SADI-S/OADS is worse than LSG regarding post operative hypoalbuminaemia leading to more lower limb edema.