Background

Duodenal switch (DS) is one of the most important malabsorptive procedures for obesity treatment. A variant of the BPD-DS, called the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), has been recently accepted by bariatric societies. It decreases the number of anastomosis and surgical time of DS. The aim of that paper is to present long term outcomes and acute-chronic complications. Patients and method: A retrospective analysis of a prospective database of all patients who underwent a SADI-S. Results: 48 patients were underwent a SADI-S between 2010 and 2019. Most of all (89%) were underwent a SADI-S as a second step after Sleeve gastrectomy and 35 of them were women (73%). The mean age was 46.3±9.5 with a preoperative body mass index (BMI) of 40.8±4.6 Kg/m2. The common channel was performed in three different measurements: 200 (4), 250 (17) and 300 cm (27). The patients were discharged after 3±3.2 days. Follow-up time was 33±5.8 months and percent of excess weight loss (%EWL) was 63.8% (table 1). The main complications were duodenoileal anastomosis leakage in 6.2% and hypoalbuminemia in 14.5% (Figure 1). The last ones needed a proximalization of the anastomosis. Three cases presented severe GERD and needed hiatoplasty (1 case) and conversion to Gastric bypass (2 case). The mortality rate was 0%. Weight regain appeared in all patients with proximalization anastomosis.

Conclusions

SADI-S presented a good result as a malabsorptive procedure in our casuist. Meticulous follow-up of patients is important in order to identify complications and treat adequately.