Record Detail

Background Owing to the possibility of weight regain after
the long-term follow-up of gastric bypass patients and because
of the high morbidity of biliopancreatic diversion with duodenal
switch, single-anastomosis duodeno-ileal switch (SADIS)
has emerged as a rescue procedure in bariatric surgery.
Objective The purpose of this review is to summarize the
literature data on SADIS.
Setting University Hospital, NY.
Methods A comprehensive literature review was performed
through October 2016 to identify English studies on SADIS
performed in human subjects. Outcomes of interest were technical
considerations, postoperative complications, weight loss
outcome, comorbidity resolution rate, and nutritional deficiency
after SADIS.
Results A total of 12 studies including 581 SADIS patients
(217 males and 364 females) were included. SADIS was a
primary procedure in 508 patients (87.4%) and a conversion
procedure in 73 patients (12.6%). The length of common limb
was 300 cm in 54.2%, 250 cm in 23%, and 200 cm in 13.4%
of patients. Anastomosis technique was a linear stapler in
26.7% and a hand sewn suture technique in 73.3% of patients.
Diarrhea was the most common complication (1.2%). The
average %EWL was 30% at 3 months, 55% at 6 months,
70% at 1 year, and 85% at 2 years. Co-morbidity resolution
rate was 74.1% for type 2 diabetes mellitus, 96.3% for hypertension,
68.3% for dyslipidemia, 63.3% for obstructive sleep
apnea, and 87.5% for GERD. Overall, vitamin A, selenium,
and iron deficiency were the most common nutritional deficiencies
with the possibility of the protein malnutrition in up
to 34% of the patients when measured.
Conclusion As a modified bariatric procedure, SADIS has
promising outcomes for weight loss and comorbidity resolution
in morbidly obese patients. When measured, there was a
high prevalence of macro-nutrient deficiencies following
SADIS. There is a high technical variability, and long-term
data are required before any meaningful conclusion can be
made.