Matched Short-Term Results of SADI Versus GBP After Sleeve Gastrectomy

Background The gastric bypass (GBP) is the most popular revisional technique after sleeve gastrectomy (SG). However, the results after revision are not always satisfactory in terms of additional weight loss and complications. The single anastomosis duodenoileal bypass (SADI) could be a valuable alternative. Objective This study is a retrospective matched-control study reviewing short-term results in terms of weight loss and comorbidities reduction of both SADI and GBP as a revisional procedure after primary sleeve gastrectomy. Complications and vitamin deficiencies will be evaluated as well. Methods Patients with a SADI procedure after a primary sleeve gastrectomy (SG) with a minimum follow-up of 1 year were included. Their results were retrospectively reviewed and matched with a cohort of GBP patient on age, BMI, and gender. Comparison was on comorbidities, weight loss, complications, and blood markers. Results A total of 64 patients were included, 32 SADI procedures and 32 matched gastric bypasses with no significant differences on baseline. No differences were found in terms of (additional) total weight loss. The operating time of the SADI was significantly longer ( p = 0.007). No clinically relevant differences were found concerning comorbidities or blood markers. In the SADI group, more defecation problems were reported and fewer vitamin deficiencies were encountered. Conclusion Based on a small group and short-term results, the SADI could be regarded as a safe alternative to a GBP following SG with a similar amount of additional weight loss and fewer post-operative early complications. Longer follow-up and larger studies are needed to determine its full potential.