Early- and Medium-Term Outcomes for a Single-Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy: A Narrative Review

Abstract

Background:

Few studies offer direct comparison of single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch (BPD-DS).

Purpose:

To (1) conduct a narrative review of early- and medium-term weight, glycemic control, and postoperative outcomes for SADI-S and SADI-fashioned procedures; (2) compare these outcomes with those of RYGB, SG, and BPD-DS; and (3) discuss quality and limitations of the currently available literature.

Methods:

Full-length English language studies from 2007 to 2020 were identified. Outcomes of interest included postoperative body mass index (BMI) and percent excess weight loss (%EWL), glycemic control, remission of type 2 diabetes mellitus (T2DM), and postoperative complications. Quality of studies was evaluated using Murad's classification of study design.

Results:

All studies reported a postoperative BMI <30 kg/m² after year 2, and %EWL range from 38% to 114%. Reported T2DM remission rate after 5 years ranged from 52% to 100%. Common postoperative complications included anastomotic leaks, nausea, and vomiting. Overall quality of published studies was low to medium with a lack of follow-up beyond 5 years.

Conclusion:

There is low to medium quality evidence in support of SADI-S as a primary bariatric procedure in patients with severe obesity; however, prospective controlled trials are required to confirm these findings.