Biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) result in distinct post-prandial hormone profiles

Pereira, Sofia S; Guimarães, Marta; Almeida, Rui; Pereira, Ana Marta; Lobato, Carolina B.; Hartmann, Bolette; Hilsted, Linda; Holst, Jens J.; Nora, Mário; Monteiro, Mariana P.

doi:10.1038/s41366-018-0282-z

Cited by 38 publications

(17 citation statements)

References 42 publications

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“…It results equally effective as a second-step or revisional operation after sleeve gastrectomy [ 12 – 14 ]. Results on diabetes are comparable to those obtained with the duodenal switch [ 15 ], and some studies have even found a better metabolic effect thanks to the longer common channel [ 16 ].…”

Section: Introductionsupporting

confidence: 58%

“…The anastomosis of the duodenum with the proximal ileum reduces carbohydrate absorption because most of the hexose transporters of the intestinal cells are located in the jejunal mucosa [ 27 ]. This is shared by the Scopinaro procedure, DS, and SADI-S, but in this last one, as the common channel is longer glucose absorption is higher what results in a higher postprandial glycemia [ 16 ]. On the other hand, the longer absorptive intestinal length increases the time of interaction between the bile acids and the membrane of the enterocytes where the TGR5 receptors stimulate the secretion of GLP-1, hence improving glycemic control in diabetics [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…This is shared by the Scopinaro procedure, DS, and SADI-S, but in this last one, as the common channel is longer glucose absorption is higher what results in a higher postprandial glycemia [ 16 ]. On the other hand, the longer absorptive intestinal length increases the time of interaction between the bile acids and the membrane of the enterocytes where the TGR5 receptors stimulate the secretion of GLP-1, hence improving glycemic control in diabetics [ 16 ]. Regarding dyslipidemia, although 53% of the patients had some alteration of the lipid profile, the individual analysis revealed triglyceride alterations in 20% of the patients, HDL in 10%, LDL in 36%, and total cholesterol in 8.5%, numbers slightly worse than those reported after DS [ 20 ], what is surely secondary to the increased length of the common channel were fat is absorbed.…”

Section: Discussionmentioning

confidence: 99%

“…-More than 70% of diabetics on insulin therapy are off medication at 10 years. obtained with the duodenal switch [15], and some studies have even found a better metabolic effect thanks to the longer common channel [16].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

et al. 2022

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Background Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of the duodenal switch (DS) in which the alimentary limb is eliminated, and the common channel is lengthened from 200 to 300 cm. Short-term results have demonstrated that SADI-S is safe and reproducible and that weight loss and comorbidities resolution are comparable to biliopancreatic diversion or DS. Objective To analyze the long-term outcomes of SADI-S. Methods From May 2007 to December 2015, 164 patients were consecutively submitted to a one-step SADI-S. The mean age was 47 years, and the mean body mass index (BMI) was 45.8 kg/m2. A total of 101 patients had type 2 diabetes, 91 arterial hypertension, 81 obstructive apnea, and 118 dyslipidemia. Limb length was 200 cm in 50 cases, 250 cm in 99, and 300 cm in 15. Results There was no mortality. One patient had a gastric leak, and 2 patients had an anastomotic leak. A total of 25% of the patients were lost to follow-up at 10 years. Excess weight loss and total weight loss were 87% and 38% at 5 years and 80% and 34% at 10 years. A total of 12 patients were submitted to revisional surgery for hypoproteinemia. Preoperatively 41 diabetics were under insulin treatment; at 5 years, 7 remained with insulin and 12 at 10 years. Mean glycemia was 104 mg/dL at 5 years and 118 mg/dL at 10 years. Mean HbA1c was 5.51% at 5 years and 5.86 at 10 years. Conclusion In the long term, SADI-S offers satisfactory weight loss and comorbidities resolution. Graphical Abstract

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Section: Introductionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

et al. 2022

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“…SADI-S has been demonstrated to be a safe and reproducible technique and offers good weight loss results in the short term (66,67). Results on diabetes are comparable to those obtained with the duodenal switch (68), and some studies have even found a better metabolic effect thanks to the longer common channel (69,70).…”

Section: Single Anastomosis Duodenoileal Bypass With Sleeve Gastrecto...mentioning

confidence: 91%

Surgical Treatment of Obesity. Special Mention to Roux-en-Y Gastric Bypass and Vertical Gastrectomy

et al. 2022

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IntroductionThe prevalence of obesity has increased exponentially in recent decades, being one of the diseases that most affects global health. It is a chronic disease associated with multiple comorbidities, which lead to a decrease in life expectancy and quality of life. It requires a multidisciplinary approach by a specialized medical team. Obesity can be treated with conservative or with surgical treatments that will depend on the characteristics of the patient.Objective/MethodologyThe referenced surgery can be performed using different surgical techniques that are analyzed in the present work through an exhaustive narrative bibliographic review in the PubMed and Cochrane databases, as well as in UpToDate.ResultsCurrently, those most used are restrictive techniques, specifically vertical gastrectomy and mixed techniques, with gastric bypass being the “gold standard”.ConclusionsIn order to choose one technique or another, the characteristics of each patient and the experience of the surgical team must be taken into account.

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Endoscopic Treatment of Weight Regain in Duodenal Switch

Grecco

Souza

Neto

et al. 2023

Duodenal Switch and Its Derivatives in Bariatric and Metabolic Surgery

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Biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) result in distinct post-prandial hormone profiles

Cited by 38 publications

References 42 publications

Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

Surgical Treatment of Obesity. Special Mention to Roux-en-Y Gastric Bypass and Vertical Gastrectomy

Endoscopic Treatment of Weight Regain in Duodenal Switch

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