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SADIS − Single anastomosis duodeno-ileal bypass with sleeve gastrectomy as a second step after sleeve gastrectomy


Authors: M. Kasalický 1,2;  E. Koblihová 1;  J. Pažin 1
Authors‘ workplace: Chirurgická klinika 2. lékařské fakulty Univerzity Karlovy a Ústřední vojenská nemocnice, Praha 1;  Fakulta zdravotníctva a sociálnej práce, Trnavská univerzita 2
Published in: Rozhl. Chir., 2019, roč. 98, č. 2, s. 52-57.
Category: Original articles

Overview

Introduction:

Sleeve gastrectomy (SG) is the most popular bariatric method at present. In case of unsatisfactory effect of the SG, i.e. in case of insufficient weight loss, improving or threatening diabetes or metabolic syndrome or regain of weight, bariatry offers a second possible step. One of the possible methods is biliopancreatic diversion type SADIS (BPD/SADIS).

Method:

Between the years 2009 and 2017, 327 morbidly obese patients underwent laparoscopic sleeve gastrectomy at our surgical department. Between mid-2011 to the end of 2017, 37 (11.3 %) patients after SG with unsatisfactory effect on diabetes or on metabolic syndrome or in case of weight regain in 23.7 (15−48) months after the SG underwent the second step - BPD/SADIS. The weight loss, change of the BMI and level of the HbA1c were evaluated during two years after procedure.

Results:

31 (83.7 %) patients were evaluated, the others were rejected due to an incomplete follow-up (FU) or a short time elapsed since the procedure. Two years after the SADIS, the average %EBMIL was 47.1 (41.5−52.7) %, average %EWL was 73.9 (65.1−83.7) %, average final BMI was 29.4 (24.6-38.2) kg/m2, which means average decrease of the BMI was 9.3 (2.9−14.1) kg/m2. Average level of the HbA1c was 37.9 (28−42) mmol/mol, type 2 diabetes was cured in 20 (64.5 %) cases.

Conclusion:

Biliopancreatic diversion type SADIS offers a satisfactory weight loss effect as well as an improvement of the metabolic syndrome in morbidly obese patients after SG with unsatisfactory result. In comparison with the classic BPD/DS, SADIS is a technically easier method with lesser incidence of complications along with acceptable rate of malnutrition.

Keywords:

Morbid obesity – diabetes – bariatry – sleeve gastrectomy – SADIS


Sources
  1. Angrisani L. Bariatric surgery worldwide 2014. Obes Surg 2015;25:1822−32.
  2. Kunešová M a kol. Základy obezitologie. Praha, Galén 2016.
  3. Kasalický M, Bařinka A, Čierny M, et al. 10 let sleeve gastrectomy − tubulizace žaludku v České republice z hlediska operačního výkonu. Rozhl Chir 2016;95:425−31.
  4. Gagner M, Hutchinson C, Rosenthal R. Fifth International Consensus Conference: current status of sleeve gastrectomy. Surg Obes Relat Dis 2016;12:750−6.
  5. Deitel M, Gagner M, Erickson AL, et al. Third International Summit: Current status of sleeve gastrectomy. Surg Obes Relat Dis 2011;7:749–59.
  6. Sánchez-Pernaute A, Rubio MA, Pérez Aguirre E, et al. Single-anastomosis duodeno ileal bypas swith sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis 2013;9:731–5.
  7. Sánchez-Pernaute A, Rubio Herrera MA, Pérez-Aguirre E, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg 2007;17:1614−8.
  8. Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial − a prospective controlled intervention study of bariatric surgery. J Intern Med 2013;273:219−34.
  9. Shoar S, Poliakin L, Rubenstein R, et al. Single anastomosis duodeno-ileal switch (SADIS): A systematic review of efficacy and safety. Obes Surg 2018;28:104−3.
  10. Balibrea JM, Vilallonga R, Hidalgo M, et al. Mid-term results and responsiveness predictors after two-step single-anastomosis duodeno-Ileal bypass with sleeve gastrectomy. Obes Surg 2017;27:1302−8.
  11. Škrha J, Pelikánová T, Kvapil M. Doporučený postup péče o diabetes mellitus 2. typu. Česká diabetologická společnost ČLS JEP. Available from. http://www.diab.cz/dokumenty/standard_lecba_dm_typ_II.pdf.
  12. Sánchez-Pernaute A, Rubio MÁ, Cabrerizo L, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis 2015;11:1092−8.
  13. Lee WJ, Almulaifi AM, Tsou JJ, et al. Duodenal-jejunal bypass with sleeve gastrectomy versus the sleeve gastrectomy procedure alone: the role of duodenal exclusion. Surg Obes Relat Dis 2015;11:765−70.
  14. Ceriani V, Pinna F, Lodi T, et al. Revision of biliopancreatic diversion for side effects or insufficient weight loss: Codification of a new procedure. Obes Surg 2017;27:1091−7.
Labels
Surgery Orthopaedics Trauma surgery
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