Single-anastomosis duodenoileal bypass with sleeve gastrectomy(SADI-S)as the revisional surgery of laparoscopic adjustable gastric banding (LAGB): Short-term efficacy and safety

Objective To explore the efficacy and safety of single-anastomosis duodenoileal bypass with sleeve gastrectomy(SADI-S)as the revisional surgery of laparoscopic adjustable gastric banding (LAGB)according to the two-year follow-up results. Methods From November 2013 to November 2015, a total of 22 weight-regain patients that underwent previous LAGB, were given SADI-S as the revisional surgery at PLA General Hospital. Preoperative clinical characteristics as well as the data at the intervals of 1, 3, 6, 12, 18 and 24months after operation were collected and analyzed. Results The operation time of SADI-S was (105±12.2) min, and the intraoperative blood loss was (27.3±5.8) ml. The excess weight loss rate (%EWL) was (20.55±9.10) %, (40.1±6.02) %, (63.52±10.43)%, (70.72±8.54) %, (78.34±9.25) %, and (81.57±11.12)% at 1, 3, 6, 12, 18, 24months after the operation, respectively. The two-year complete remission rate of T2DM was 17/18, and the corresponding partial remission rate was 1/18 after operation. One case experienced trocar hernia and was repaired. There was no conversion to laparotomy. Vitamins and trace elements were administrated for these patients a long time after operation, and no patients experienced the deficiency of vitamin and trace element. Conclusion SADI-S is safe and effective as a revisional surgery for patients whose weight regain after LAGB. However, multicenter randomized controlled studies with large sample sizes are needed to explore the long-term efficacy and safety of SADI-S. Key words: Diabetes Mellitus, Type 2; Obesity; Laparoscopy; Gastrectomy; Treatment Outcome