The rationale for a duodenal switch as the primary surgical treatment of advanced type 2 diabetes mellitus and metabolic disease

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

“…Mingrone et al [49] showed that the more the small intestine is bypassed, the higher the T2D resolution rates. Roslin et al [50] have shown greater glycemic control with duodenal switch than RYGB. Our study also showed higher T2D resolution rates compared with LRYGB with a statistically significant difference.…”

Mid-term outcomes of gastric bypass weight loss failure to duodenal switch

“…When RYGB patients come to clinic after weight-loss failure they almost always are eating small, frequent, high-carbohydrate meals. We believe this is a physiologic response to vacillating blood sugar 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 levels [8]. Huang et al [24] present their experience with a patient who had inadequate weight loss and dumping syndrome after RYGB and underwent surgical revision to modified DS with immediate resolution of the dumping syndrome.…”

“…Next, a long section of small intestine is bypassed to limit absorption of food. Perhaps most importantly, the pylorus is preserved to help maintain consistent blood sugars [8].…”

Sadi-S With Right Gastric Artery Ligation: Technical Systematization and Early Results

“…During the next years, SADI-S has been gaining popularity and some other groups all over the world added it to their bariatric surgical portfolio. Nowadays we may find several references about SADI-S in some published articles and at any national or international meeting of bariatric surgery 8 , 21 , 28 .…”

“…The main reasons for such conservative recommendation numbers is that both, biliopancreatic diversion and DS are usually associated with the high morbidity and mortality rates, high technical complexity and elevated long-term nutritional sequelae. However, if we carefully examine the more recent literature about DS we may find studies with large follow-up pointing for good results and few complication numbers but even though this literature is unanimous, this is the technically most demanding and complex bariatric procedure 23 , 28 .…”