Single Anastomosis Duodenoileostomy with Sleeve: A Comprehensive Review of Anatomy, Surgical Technique, and Outcomes

Abi Mosleh, Kamal; Belluzzi, Amanda; Jawhar, Noura; Marrero, Katie; Al-Kordi, Mohammad; Hage, Karl; Ghanem, Omar M.

doi:10.1007/s13679-023-00535-y

Curr Obes Rep

2024

DOI: 10.1007/s13679-023-00535-y

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Single Anastomosis Duodenoileostomy with Sleeve: A Comprehensive Review of Anatomy, Surgical Technique, and Outcomes

Kamal Abi Mosleh,

Amanda Belluzzi,

Noura Jawhar

et al.

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2024

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Cited by 3 publications

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Evaluating the incidence, risk factors and postoperative complications associated with leaks following duodenal switch procedures: an analysis of the MBSAQIP

Abi Mosleh,

Corbett,

Salameh

et al. 2024

Surgery for Obesity and Related Diseases

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Evaluating the incidence, risk factors and postoperative complications associated with leaks following duodenal switch procedures: an analysis of the MBSAQIP

Abi Mosleh,

Corbett,

Salameh

et al. 2024

Surgery for Obesity and Related Diseases

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Internal hernia in patients after duodenal switch: A multi‐centred comparative analysis

Lind,

Goncalves,

Belluzzi

et al. 2024

Clinical Obesity

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SummaryBiliopancreatic diversion with duodenal switch (BPD‐DS) and single anastomosis duodeno‐ileostomy with sleeve (SADI‐S) are associated with superior and sustained weight loss outcomes. Despite their growing popularity, long‐term safety profiles, particularly the risk of internal hernia (IH), remain underexplored. This study aimed to evaluate the incidence and characteristics of IH following BPD‐DS and SADI‐S procedures, comparing their clinical presentation, diagnostic methods, and outcomes. A retrospective chart review was performed for patients who underwent BPD‐DS or SADI‐S between 2008 and 2023 in two high‐volume tertiary referral centres for bariatric surgery in the United States. Demographic data, comorbidities, operative details, and follow‐up outcomes were collected. A subgroup analysis of IH cases was conducted to compare the incidence, location of hernias, and diagnostic modalities between procedures. Out of 1160 patients (85.1% BPD‐DS; 14.9% SADI‐S), the overall incidence of IH was 1.12%, with a higher rate in BPD‐DS (0.8%) than in SADI‐S (0.57%). Most IHs occurred within the first 24 months postoperatively. The majority of IHs in BPD‐DS patients were in the pseudo‐Petersen's space. The single IH case in the SADI‐S group occurred in the same space. Most patients presented with abdominal pain and were diagnosed by CT imaging. SADI‐S showed a lower IH rate compared to BPD‐DS, but further studies are needed to confirm these findings. The variability in clinical presentation complicates the diagnosis of IH, emphasizing the need for increased clinical vigilance.

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Pre-Operative Gastroesophageal Reflux Does Not Affect 30-Day Outcomes in Patients Undergoing Revisional Bariatric Surgery to Single Anastomosis Duodeno-Ileal Bypass (SADI): An Analysis of 933 Metabolic and Bariatric Accreditation and Quality Improvement Program Patients

Meyer,

Mocanu,

Switzer

et al. 2024

JCM

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Background: The use of a single anastomosis duodeno-ileal bypass (SADI) as a revisional procedure in patients with pre-operative GERD is not well understood. Thirty-day outcomes in patients with pre-existing GERD undergoing revision with an SADI have not been previously reported. Methods: The Metabolic and Bariatric Accreditation and Quality Improvement Program registry was consulted to identify patients undergoing revisional bariatric surgery with an SADI between 2020 and 2021. Our analysis sought to determine if preoperative GERD had significant impact on thirty-day outcomes. Bivariate and multivariable logistic regression analyses were used to identify independent predictors of 30-day morbidity. Results: Preoperative GERD was seen in 342 patients (36.7%). Preoperative GERD was not associated with anastomotic leak (2.5% non-GERD cohort vs. 1.2% GERD cohort; p = 0.2) nor bleeding (1% non-GERD cohort vs. 1.8% GERD cohort; p = 0.33). There was no difference in thirty-day readmission (5.6% vs. 5.9%, p = 0.9), reintervention (2.4% vs. 1.2%, p = 0.2), or reoperation (3.6% vs. 2.05%; p = 0.19) rates. The multivariable regression analysis revealed that a history of myocardial infarction was associated with a significantly elevated risk of serious complication (OR 12.2; 95% CI 2.79–53.23; p = 0.001), as was dyslipidemia (OR 2.2; 95% CI 1.04–4.56; p = 0.04). Conclusions: Pre-operative GERD does not have any association with anastomotic leak, bleeding, thirty-day readmission, reintervention, or reoperation in patients undergoing revisional bariatric surgery to SADI. A history of myocardial infarction and dyslipidemia are independent predictors of post-operative thirty-day morbidity, irrespective of the presence of preoperative GERD.

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Single Anastomosis Duodenoileostomy with Sleeve: A Comprehensive Review of Anatomy, Surgical Technique, and Outcomes

Cited by 3 publications

References 75 publications

Evaluating the incidence, risk factors and postoperative complications associated with leaks following duodenal switch procedures: an analysis of the MBSAQIP

Evaluating the incidence, risk factors and postoperative complications associated with leaks following duodenal switch procedures: an analysis of the MBSAQIP

Internal hernia in patients after duodenal switch: A multi‐centred comparative analysis

Pre-Operative Gastroesophageal Reflux Does Not Affect 30-Day Outcomes in Patients Undergoing Revisional Bariatric Surgery to Single Anastomosis Duodeno-Ileal Bypass (SADI): An Analysis of 933 Metabolic and Bariatric Accreditation and Quality Improvement Program Patients

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