Clinical outcomes and complications of single anastomosis duodenal-ileal bypass with sleeve gastrectomy: A 2-year follow-up study in Bogotá, Colombia

Andres Ospina Jaramillo; Angie Carolina Riscanevo Bobadilla; Mariana Ospina Espinosa; Alvaro Valencia; Humberto Jiménez; Maria Del Pilar Montilla Velásquez; Maria Bastidas

doi:10.12998/wjcc.v11.i21.5035

Clinical outcomes and complications of single anastomosis duodenal-ileal bypass with sleeve gastrectomy: A 2-year follow-up study in Bogotá, Colombia

World J Clin Cases. 2023 Jul 26;11(21):5035-5046. doi: 10.12998/wjcc.v11.i21.5035.

Authors

Andres Ospina Jaramillo¹, Angie Carolina Riscanevo Bobadilla², Mariana Ospina Espinosa³, Alvaro Valencia¹, Humberto Jiménez¹, Maria Del Pilar Montilla Velásquez⁴, Maria Bastidas¹

Affiliations

¹ Department of General Surgery, Clínica Reina Sofia, Colsanitas, Bogotá D.C 110151, Colombia.
² Department of General Surgery, Fundación Universitaria Sanitas, Bogotá D.C 11162, Colombia. caroriscanevo@gmail.com.
³ Department of General Surgery, Universidad del Rosario, Bogotá 110151, Colombia.
⁴ Department of Epidemiology, Fundación Universitaria Sanitas, Bogotá 110151, Colombia.

Abstract

Background: The global prevalence of obesity has increased over the past 40 years, and bariatric surgery has proven to be the most effective therapy for long-term weight loss. Its principles are based on modifying the brain-gut axis by altering the gastrointestinal anatomy and affecting the function of gastrointestinal hormones, thereby modifying satiety signals. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) combines both techniques and has become an alternative to gastric bypass and biliopancreatic diversion procedures for treating severe obesity and associated metabolic diseases in selected patients.

Aim: To describe the outcomes and complications of SADI-S.

Methods: We retrospectively analyzed the data of patients who underwent SADI-S laparoscopically at the Clínica Reina Sofía in Bogotá, Colombia. This study assessed the therapeutic effectiveness of SADI-S in terms of short-term preoperative clinical characteristics, postoperative complications, comorbidities, nutritional defi-ciencies, and intraoperative complications during a 2-year follow-up.

Results: Sixty-one patients with a mean body mass index (BMI) of 50 ± 7.1 kg/m² underwent laparoscopic SADI-S. The mean operative time and hospital stays were 143.8 ± 42 min and 2.3 ± 0.8 d, respectively. The mean follow-up period was 18 mo, and the mean BMI decreased to 28.5 ± 12.2 kg/m². The excess BMI loss was 41.8% ± 13.5%, and the weight loss percentage was 81.1% ± 17.0%. Resolution of obesity-related comorbidities, including type 2 diabetes mellitus, hypertension, dyslipidemia, and obstructive sleep apnea, was achieved and defined as complete or partial remission. No intraoperative complications were observed. Short-term complications were observed in four (6.8%) patients. However, larger studies with longer follow-up periods are required to draw definitive conclusions.

Conclusion: SADI-S has a low intraoperative and postoperative complication rate and is effective for weight loss and improving obesity-related comorbidities, including hypertension, type 2 diabetes mellitus, dyslipidemia, and sleep apnea syndrome.

Keywords: Bariatric surgery; Body mass index; Cardiovascular diseases; Complications; Extreme obesity; Metabolic syndrome.