Mid-Term Results and Responsiveness Predictors After Two-Step Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy

José M. Balibrea, Ramón Vilallonga, Marta Hidalgo, Andreea Ciudin, Óscar González, Enric Caubet, Andrés Sánchez-Pernaute, José M. Fort, Manel Armengol-Carrasco

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47 Citations (Scopus)


© 2016, Springer Science+Business Media New York. Background: In patients with insufficient weight loss after sleeve gastrectomy (SG) or in super obese individuals, among many surgical options available, a single-anastomosis duodeno-ileal bypass (SADI) after SG (SADI-S) could be considered. Due to the limited information available about the use of SADI as a second-step procedure, the objective of this study was to evaluate the mid-term results and responsiveness of SADI after sleeve gastrectomy. Methods: We present prospective data from 30 consecutive patients with a mean BMI of 40.1 kg/m2, a mean excess weight of 44.7 kg, and a mean excess weight loss (EWL) of 37.5%, who were submitted to a SADI as a second-step revisional procedure. Results: There were no intraoperative complications. Four early complications (13.34%) occurred within the first 24 postoperative hours. Six., 12, and 24-month follow-up number of patients available was 30 (100%), 22 (73.3%), and 16 (53.34%), respectively. Percent total weight loss (%WL) was 28.1 at the time of revision and 46.26% 24 months after SADI. Global %EWL was 78.93 ± 35.5. The complete remission rate after SG was 50% for diabetes, 33.3% for dyslipidemia, and 25% for hypertension, and 71.4%, 31.2%, and 27.7%, respectively, after SADI. Three (10%) patients required revisional surgery due to hypoalbuminemia. Conclusions: SADI as a second-step strategy in super obese patients or after failed SG offers a more than satisfactory ponderal weight loss and an acceptable comorbidities resolution. However., the risk of severe malnutrition after distal SADI-S makes necessary a careful patient selection.
Original languageEnglish
Pages (from-to)1302-1308
JournalObesity Surgery
Issue number5
Publication statusPublished - 1 May 2017


  • Duodeno-ileal bypass
  • Obesity
  • SADI-S
  • Sleeve gastrectomy
  • Weight loss


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