TY - JOUR
T1 - Mid-Term Results and Responsiveness Predictors After Two-Step Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy
AU - Balibrea, José M.
AU - Vilallonga, Ramón
AU - Hidalgo, Marta
AU - Ciudin, Andreea
AU - González, Óscar
AU - Caubet, Enric
AU - Sánchez-Pernaute, Andrés
AU - Fort, José M.
AU - Armengol-Carrasco, Manel
PY - 2017/5/1
Y1 - 2017/5/1
N2 - © 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.
AB - © 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.
KW - Duodeno-ileal bypass
KW - Obesity
KW - SADI-S
KW - Sleeve gastrectomy
KW - Weight loss
U2 - 10.1007/s11695-016-2471-y
DO - 10.1007/s11695-016-2471-y
M3 - Article
SN - 0960-8923
VL - 27
SP - 1302
EP - 1308
JO - Obesity Surgery
JF - Obesity Surgery
IS - 5
ER -