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- Title
A Multi-institutional Study on the Mid-Term Outcomes of Single Anastomosis Duodeno-Ileal Bypass as a Surgical Revision Option After Sleeve Gastrectomy.
- Authors
Zaveri, Hinali; Surve, Amit; Cottam, Daniel; Ng, Peter C.; Enochs, Paul; Billy, Helmuth; Medlin, Walter; Richards, Christina; Belnap, LeGrand; Sharp, Lindsey S.; Bermudez, Dustin M.; Fairley, Ryan; Burns, Tricia A.; Herrell, Krista; Bull, Jaime; Menozzi, Sophia E.; Student, John Ambrose
- Abstract
Introduction: Recently, a single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has become increasingly popular for patients with BMI > 50 as a primary or staged surgery. Staging allows surgeons to do the sleeve gastrectomy (SG) first with the conversion only happening when a failure or technical challenge is identified. Purpose: We present the mid-term outcomes of SADI bypass surgery after SG. Method: A retrospective analysis was performed on a prospective database from four institutions. Ninety-six patients were identified from 2013 to 2018. Patients were divided into two groups: one had two-stage SADI because of insufficient weight loss, the second had planned two-stage SADI because of super obesity (BMI > 50 kg/m2). Incidence of complications was divided into < 30 days and > 30 days. Result: Of 96 patients, 3 patients were completely lost to follow-up. The mean age was 44.8 ± 11.3 years. There were no deaths or conversion to open surgery. The postoperative early complication and late complication rate was 5.3% and 6.4% respectively. At 24 months, group 2 had higher %weight loss (WL) and change in BMI units compared to group 1 with statistically significant difference. The average WL and change in BMI for entire patient's population at 24 months after 2nd stage SADI was 20.5% and 9.4 units respectively. The remission rate for DM was 93.7% with or without the use of medication. Conclusion: The two-stage approach to SADI-S appears technically simpler than a single compromised operation. However, this approach needs more patients to understand its limitations.
- Subjects
REOPERATION; SLEEVE gastrectomy; WEIGHT loss; SURGICAL complications
- Publication
Obesity Surgery, 2019, Vol 29, Issue 10, p3165
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-019-03917-1