Single- Versus Double-Anastomosis Duodenal Switch: Outcomes Stratified by Preoperative BMI

• Published in: Obesity surgery Vol. 32; no. 12; pp. 3869 - 3878
• Main Authors: Lind, Romulo P., Ghanem, Muhammad, Teixeira, Andre F., Jawad, Muhammad A., Osorio, Javier, Lazzara, Claudio, Sobrino, Lucia, Ortiz-Ciruela, David, de Gordejuela, Amador Garcia Ruiz
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2022; Springer Nature B.V
• Subjects: Comorbidity; Emergency medical care; Gastrointestinal surgery; Laparoscopy; Medicine; Medicine & Public Health; Metabolism; Obesity; Original Contributions; Small intestine; Surgery; Weight control; BPD-DS; Duodenal switch; Bariatric surgery; Weight loss; SADI-S
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-022-06315-2

Purpose Describe and analyze the safety and weight loss performance of biliopancreatic diversion and duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), verifying any possible superiority according to preoperative BMI. Methods Retrospective review of patients who underwent primary SADI-S or BPD-DS in three bariatric centers. Study groups were further stratified according to preoperative BMI (subgroup 1: BMI < 50; subgroup 2: 50 ≤ BMI < 55; subgroup 3: BMI ≥ 55). Results Four hundred and sixty patients underwent BPD-DS ( n  = 220) or SADI-S ( n  = 240). The mean LOS was 3.48 ± 3.7 and 3.13 ± 2.3 days for BPD-DS and SADI-S respectively ( p  = 0.235). The mean operative time was shorter in the SADI-S group (167.25 ± 33.6 vs 140.85 ± 56.7 min) ( p  < 0.00). The mean %EWL was 44.2, 62.4, and 69.4 for the BPD-DS group and 48.4, 64.5, and 67.1 for the SADI-S group at 6, 12, and 24 months respectively. The mean %TBWL was 25, 35.9, and 40.3 for the BPD-DS group, and 26.2, 35, and 36.9 for the SADI-S group at 6, 12, and 24 months respectively. Overall complication rates were comparable between BPD-DS and SADI-S groups (14% vs 18%) ( p  = 0.219). SADI-S showed greater emergency department visits (17% vs 7%) ( p  = 0.005); similar readmission rates (6% vs 7%) ( p  = 0.80); similar reoperation rates (3% vs 7%) ( p  = 0.102); and similar mortality rate (0.9% vs 0.4%), after BPD-DS and SADI-S respectively. Conclusion BPD-DS achieved greater %TBWL at 2 years, but no superiority was perceived among study subgroups. SADI-S and BPD-DS showed similar overall complication rates. Graphical abstract