Early results of laparoscopic single‑anastomosis duodeno‑ileal bypass with sleeve gastrectomy: a case series from a single Polish bariatric center.

Introduction: The obesity epidemic has led to an increased prevalence of related conditions, such as type 2 diabetes (T2D) and hypertension. While laparoscopic sleeve gastrectomy is the most common metabolic bariatric surgery, up to 50% of patients may require revisional procedures due to weight regain or comorbidity recurrence. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is emerging as an effective treatment option with promising short-term outcomes.

Aim: This study aimed to present the outcomes of patients who underwent SADI-S or revisional SADI.

Materials and methods: This retrospective, single-center cohort study included 12 patients who underwent SADI-S or SADI between February 2023 and March 2024. The patients were assessed for percentage of total weight loss (%TWL), remission of T2D and hypertension, length of hospital stay, operative time, and complications. All outcomes were reported according to the American Society for Metabolic and Bariatric Surgery standards.

Results: A total of 9 patients underwent primary SADI-S and 3 underwent revisional SADI. The mean (SD) %TWL was 27.9% (4.3%) at 6 months and 31.1% (5.9%) at 12 months after SADI and 21.2% (15.2%) and 14% (7.5%), respectively, after SADI-S. The mean (SD) preoperative body mass index was 42 (5.5) kg/m2 in the primary SADI-S group and 42.4 (9.3) kg/m2 in the revisional SADI group, and the mean (SD) follow-up was 10.1 (3.4) months. Full remission of T2D and hypertension was achieved in all patients within 6 months of surgery. There were no major complications, except for 1 case of intraoperative conversion to one-anastomosis gastric bypass.

Conclusions: SADI-S is associated with significant weight loss and comorbidity resolution with a low complication rate, though larger studies are needed for further validation of these results.