The Drawbacks of Laparoscopic Single Anastomosis Duodeno-ileal Bypass-sleeve Gastrectomy versus Laparoscopic Sleeve Gastrectomy on Iron and Hemoglobin

Background: BMI can be decreased after Biliopancreatic diversion, but there is a risk of malnutrition and diarrhea. This risk may be abolished by pyloric preservation with duodenal switch. Loop duodenal switch (Single anastomosis duodeno-ileal bypass with sleeve gastrectomy=SADI-S) is hybrid intervention combining moderate food restriction with moderate malabsorption for treatment of morbid obesity, In a trial to modify the effective BPD-DS procedure- the same way Rutledge modified RYGB by creating one loop end-to-side anastomosis – and to keep its principles, the single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was first mentioned in 2007 by Sánchez-Pernaute and Torres as they fashion Sleeve gastrectomy followed by 1-loop duodenoileostomy, with 250 cm between anastomosis and ileocecal valve. Anastomosis performed in antecolic and isoperistaltic manner. Purpose to assess the drawbacks of the two procedures on iron and hemoglobin.

Patients and Methods: The interventions were led at Beni-suef University Hospital between January 2018 and December2019, after the patients fitted both the inclusions and exclusions criteria.

Results: This study consisted of 36 patients which were randomized into 2 groups. Group (A): 18 patients assigned for Single Anastomosis Duodeno-ileal bypass – Sleeve Gastrectomy [SADI-S]. Group (B): 18 patients assigned for Sleeve Gastrectomy.

Conclusion: There was drop of Hb level and iron level from baseline in both groups more in SADI patients. This drop was significant with hemoglobin and highly significant with iron. In addition longer OR time and longer hospital stay.