Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients

Published:August 09, 2012DOI:



      Single-anastomosis duodenoileal bypass with sleeve gastrectomy is a simplified 1-loop duodenal switch with a 200–250 common channel. Our objective was to analyze the weight loss and metabolic results of the technique on a series of 100 consecutively operated patients at a tertiary center university hospital.


      A total of 100 patients consecutively underwent surgery. The criteria of inclusion were morbid obesity or metabolic disease. In the first 50 cases, the common/efferent limb measured 200 cm. The length was changed to 250 cm to reduce the hypoproteinemia rate.


      No mortality and no severe complications developed. The mean excess weight loss was >95% maintained during the follow-up period. More than 90% of the patients experimented complete remission of type 2 diabetes mellitus. Two conversions to a standard duodenal switch with a longer alimentary channel were required because of recurrent hypoproteinemia. Hypertension was controlled in 98% of the patients, with a 58% remission rate. The mean number of bowel movements was 2.5/d.


      Single-anastomosis duodenoileal bypass with sleeve gastrectomy is a simplified duodenal switch procedure that is safe and quicker to perform and offers good results for the treatment of both morbid obesity and its metabolic complications.


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        • Søvik T.T.
        • Taha O.
        • Aasheim E.T.
        • et al.
        Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity.
        Br J Surg. 2010; 97: 160-166
        • Prachand V.N.
        • Ward M.
        • Alverdy J.C.
        Duodenal switch provides superior resolution of metabolic comorbidities independent of weight loss in the super-obese (BMI > or = 50 kg/m2) compared with gastric bypass.
        J Gastrointest Surg. 2010; 14: 211-220
        • Søvik T.T.
        • Aasheim E.T.
        • Taha O.
        • et al.
        Weight loss, cardiovascular risk factors, and quality of life after gastric bypass and duodenal switch: a randomized trial.
        Ann Intern Med. 2011; 155: 281-291
        • Topart P.
        • Becouarn G.
        • Ritz P.
        Comparative early outcomes of three laparoscopic bariatric procedures: sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch.
        Surg Obes Relat Dis. 2012; 8: 250-254
        • Buchwald H.
        • Estok R.
        • Fahrbach K.
        • et al.
        Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis.
        Am J Med. 2009; 122: 248-256
        • Aasheim E.T.
        • Björkman S.
        • Søvik T.T.
        • et al.
        Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch.
        Am J Clin Nutr. 2009; 90: 15-22
        • Dolan K.
        • Hatzifotis M.
        • Newbury L.
        • Lowe N.
        • Fielding G.
        A clinical and nutritional comparison of biliopancreatic diversion with and without duodenal switch.
        Ann Surg. 2004; 240: 51-56
        • Sánchez-Pernaute A.
        • Rubio Herrera M.A.
        • Pérez-Aguirre E.
        • et al.
        Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique.
        Obes Surg. 2007; 17: 1614-1618
        • Sánchez-Pernaute A.
        • Herrera M.A.
        • Pérez-Aguirre M.E.
        • et al.
        Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): one to three-year follow-up.
        Obes Surg. 2010; 20: 1720-1726
        • Sánchez-Pernaute A.
        • Pérez-Aguirre E.
        • Díez-Valladares L.
        • et al.
        “Right-angled” stapled latero-lateral duodenojejunal anastomosis in the duodenal switch.
        Obes Surg. 2005; 15: 700-702
        • Dixon J.B.
        • Zimmet P.
        • Alberti K.G.
        • Rubino F.
        • International Diabetes Federation Taskforce on Epidemiology and Prevention
        Bariatric surgery: an IDF statement for obese type 2 diabetes.
        Surg Obes Relat Dis. 2011; 7: 433-447
        • Scopinaro N.
        • Adami G.F.
        • Marinari G.M.
        • et al.
        Biliopancreatic diversion.
        World J Surg. 1998; 22: 936-946
        • Hess D.S.
        • Hess D.W.
        Biliopancreatic diversion with a duodenal switch.
        Obes Surg. 1998; 8: 267-282
        • Marceau P.
        • Biron S.
        • Bourque R.A.
        • Potvin M.
        • Hould F.S.
        • Simard S.
        Biliopancreatic diversion with a new type of gastrectomy.
        Obes Surg. 1993; 3: 29-35
        • Rutledge R.
        The mini-gastric bypass: experience with the first 1,274 cases.
        Obes Surg. 2001; 11: 276-280
        • Mason E.E.
        • Ito C.
        Gastric bypass.
        Ann Surg. 1969; 170: 329-336
        • Buchwald H.
        • Avidor Y.
        • Braunwald E.
        • et al.
        Bariatric surgery: a systematic review and meta-analysis.
        JAMA. 2004; 292: 1724-1737
        • Scopinaro N.
        Biliopancreatic diversion: mechanisms of action and long-term results.
        Obes Surg. 2006; 16: 683-689
        • Hess D.S.
        • Hess D.W.
        • Oakley R.S.
        The biliopancreatic diversion with the duodenal switch: results beyond 10 years.
        Obes Surg. 2005; 15: 408-416
        • Marceau P.
        • Biron S.
        • Hould F.S.
        • et al.
        Duodenal switch: long-term results.
        Obes Surg. 2007; 17: 1421-1430
        • Lee W.J.
        • Lee Y.C.
        • Ser K.H.
        • Chen S.C.
        • Chen J.C.
        • Su Y.H.
        Revisional surgery for laparoscopic minigastric bypass.
        Surg Obes Relat Dis. 2011; 7: 486-492
        • Pories W.J.
        • Swanson M.S.
        • MacDonald K.G.
        • et al.
        Who would have thought it?.
        Ann Surg. 1995; 222: 339-350
        • Hickey M.S.
        • Pories W.J.
        • MacDonald Jr, K.G.
        • et al.
        A new paradigm for type 2 diabetes mellitus: could it be a disease of the foregut?.
        Ann Surg. 1998; 227: 637-643
        • Rodríguez A.
        • Mosti M.
        • Sierra M.
        • et al.
        Small bowel obstruction after antecolic and antegastric laparoscopic Roux-en-Y gastric bypass: could the incidence be reduced?.
        Obes Surg. 2010; 20: 1380-1384
        • Higa K.
        • Ho T.
        • Tercero F.
        • Yunus T.
        • Boone K.B.
        Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up.
        Surg Obes Relat Dis. 2011; 7: 516-525