Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures
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ORIGINAL CONTRIBUTIONS
Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes Moataz Bashah 1,2 & Ammar Aleter 1 & Jawher Baazaoui 1 & Ayman El-Menyar 3,4
&
Antonio Torres 5 & Asaad Salama 1
Received: 28 June 2020 / Revised: 13 August 2020 / Accepted: 14 August 2020 # The Author(s) 2020
Abstract Purpose Many revisional procedures are available for unsuccessful laparoscopic sleeve gastrectomy (LSG) in patients with complications or weight recidivism. Single anastomosis duodeno-ileal bypass (SADI-S) and one anastomosis gastric bypass (OAGB-MGB) are two revisional procedures to address the problem of weight recidivism. We aimed to evaluate the efficacy and outcomes of the 2 revisional approaches (SADI-S vs. OAGB-MGB). Materials and Methods A retrospective analysis of prospectively collected database of patients who underwent SADI-S or OAGB-MGB as a revisional procedure for weight recidivism after primary LSG with a minimum 1-year follow-up. Weight loss, comorbidities, nutritional deficiencies, complications, and outcomes were compared in the 2 procedures. Results Ninety-one patients were included in the study (42 SADI-S and 49 OAGB-MGB). There was a significant weight loss (total weight loss percentage, TWL%) at 1-year follow-up observed for SADI-S when compared to OAGB-MGB (23.7 ± 5.7 vs. 18.7 ± 8.5, p = 0.02). However, this difference was not statistically significant at 18 months (26.4 ± 7.3 vs. 21.2 ± 11.0, p = 0.25). Remission of comorbidities (diabetes mellitus and hypertension) was comparable. Although OAGB-MGB had higher complication rate than SADI-S, the difference was not statistically significant (p = 0.39). No mortality was reported in the study groups. Conclusion Both SADI-S and OAGB-MGB are effective and safe revisional procedures for weight regain after LSG. The shortterm outcomes are comparable; however, SADI-S is associated with less upper gastrointestinal complications and could be a better option for patients suffering from GERD post-LSG. Moreover, the underlying bile reflux may get worse with OAGBMGB. However, further prospective larger studies are needed. Keywords Revisional surgery . Sleeve gastrectomy . Single anastomosis duodeno-ileostomy . One anastomosis gastric bypass
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04933-2) contains supplementary material, which is available to authorized users. * Ayman El-Menyar [email protected] 1
Department of Bariatric and Metabolic Surgery, Hamad General Hospital, Doha, Qatar
2
Department of Surgery, Weill Cornell Medical College, Doha, Qatar
3
Clinical Research, Trauma and Vascular Surgery Section, Hamad General Hospital, PO Box 3050, Doha, Qatar
4
Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
5
Department of Surgery, Hospital Clinico San Carlos, Complutense University of Madrid, Madrid, Spai
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