Stomach Intestinal Pylorus-Sparing Surgery for Morbid Obesity

Abstract

Background and Objective:The Roux-en-Y duodenal switch (RYDS) is one of the most efficient forms of bariatric surgery. However, diarrhea, malnutrition, ulcers, and internal hernias have hampered its widespread adoption. The stomach intestinal pylorus-sparing (SIPS) procedure was developed to alleviate these sequelae while retaining the same weight loss as the RYDS. In this study, we report our midterm experience with this novel technique.Methods:Retrospective analysis was performed on data from 225 patients who underwent a primary SIPS procedure by 2 surgeons at a single center from October 2013 through December 2016.Results:Two hundred twenty-five patients were identified for analysis. The mean preoperative body mass index (BMI) was 52.4 ± 9.1 kg/m2. Forty-eight patients were beyond 2 years after surgery, with data available for 30 patients (62.5% follow-up). Three patients were lost to follow-up. At 2 years, the patients had an average change in BMI of 26.6 U (kg/m2) with an average of 88.7% of excess weight loss. Three deaths were related to the surgery. The most common short-term complication was a leak (2.2%), whereas the most common long-term complication was diarrhea (2.2%).Conclusion:In conclusion, SIPS surgery is a safe procedure with favorable weight loss outcomes at 2 years.

Modificaciones anatómicas de la derivación biliopancreática con cruce duodenal: ¿Tienen algún rol futuro en la cirugía bariátrica y metabólica?

“…A los 12 meses, con un 62% de seguimiento, el %PEP promedio fue 72%, y no se reportaron complicaciones relacionadas con la anastomosis duodeno-ileal o mortalidad 15 . Recientemente Neichoy et al, describieron una serie con 225 pacientes a los cuales se le realizó SIPS 16 . El promedio de IMC preoperatorio fue 52,4 Kg/m 2 , y el %PEP a los 2 años de seguimiento fue 89%.…”

“…El promedio de IMC preoperatorio fue 52,4 Kg/m 2 , y el %PEP a los 2 años de seguimiento fue 89%. La remisión de DM fue 89%, y los autores reportaron solo 5 filtraciones (2,2%) de la anastomosis duodeno-ileal, y no reportaron síndrome de Dumping durante el seguimiento 16 . Cottam et al, realizaron un estudio comparativo entre SIPS versus BPD-DS 17 con 61 pacientes por rama de estudio.…”

Comparative analysis of the single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures: an assessment of 2-year postoperative data illustrating weight loss, type 2 diabetes, and nutritional status in a single US center

“…Recently, there have been several reports on the outcomes of SADI-S procedure [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. One of the articles published by Neichoy et al [16] on the midterm outcomes of SADI-S reported EWL of 88% at 24 months. This was very similar to the weight loss reported in our study.…”

“…Based on clinical knowledge, expert opinion, and published peer-reviewed scientific evidence, the International Federation for the Surgery of Obesity and Metabolic Disorders considered the SADI-S (and its variant [stomach intestinal pylorus-sparing surgery]) an established bariatric procedure [14]. In recent years, there have been few reports on the short-and mid-term outcomes of this procedure [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. In terms of weight loss, the SADI-S and RYGB had statistically similar weight loss; however, the weight loss was statistically higher in patients undergoing SADI-S procedure than SG [21,30].…”

A Feasibility Study of Novel “Laparoscopic Sleeve Gastrectomy with Loop Gastroileal Bypass” for Obesity: An Indian Experience

“…Increasing common channel length to 300 cm reduces malabsorption significantly. 11,12 But, access to the biliary tract is lost in the SADI S procedure. Sleeve gastrectomy with loop gastroileal bypass (SG LGIB; Fig.…”