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    • Single Anastomosis Duodeno-Ieal Bypass after Sleeve for Metabolic Relapse; Do we Need to Re-sleeve?

    Wael A Jumuah, MD; Yasser El Ghamrini, MD; Karim Sabry Abdel Samee, MD, MRCS (Ed)
    Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Background: Sleeve Gastrectomy (SG) is a widespread bariatric procedure which showed a relative high failure rate (up to 25%), as regards weight loss maintenance and control of obesity related comorbidities where revision in these case is needed. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is emerging as a new effective, safe and simple technique proposed for the first time by SanchezPernaute in 2007 as an alternative for Duodenal Switch (DS) because of its complexity and high rate metabolic complications. Methods: a retrospective study including 30 patients with failed gastric sleeve to achieve a good control for obesity and its related metabolic comorbidities, were operated upon using a newly emerging technique, SADI-S, to show its effectiveness and necessity to re-sleeve the sleeve pouch done before. Results: From the thirty patients, only 4 patients needed resleeve, mean preoperative body mass index (BMI) was 46.23 kg/m2 , 28 patients were diabetic, 7 were dyslipidemic, and 6 were hypertensive. After 2 years follow up, mean percentage of excess weight loss (%EWL) was >88%, remission rate for diabetes was 92.9%, for hypertension was 100% and for dyslipidemia was 71%. Conclusion: SADI-S is feasible, safe and effective bariatric procedure with low rate of complications making it a promising weight loss and comorbidity resolution procedure in patients with failed sleeve. Key words: SADI-S. Single anastomosis duodeno-ileal bypass with sleeve. Failed gastric sleeve. Metabolic relapse. Bariatric surgery.

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