Original articleA retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up
Section snippets
Aim
This study compares the midterm outcomes in terms of weight loss and complications of laparoscopic BPD-DS versus SIPS at a single institution at 2 years.
Methods
With adherence to HIPAA guidelines, 182 patients had undergone laparoscopic BPD-DS or SIPS procedure were retrospectively reviewed from a prospectively collected database. All patients were informed about the various surgical procedures for weight loss at an educational seminar before their individual evaluation in the clinic. Each patient had an informed consent to participate in our de-identified database. Each patient signed informed consent detailing the procedure, risks, and potential
Results
There were 182 patients that qualified for the study. Of these, 62 patients underwent BPD-DS between September 2011 and August 2013, while the other 120 patients underwent SIPS between June 2013 and March 2015. Out of 182 patients, 5 patients lost to follow-up. One hundred fifty-six patients are beyond 1 year postoperative mark and 99 patients are beyond 2 year postoperative mark. See Table 1, Table 2 for demographic data and operative details for BPD-DS and SIPS, respectively.
Short-term
Discussion
BPD and DS are most effective bariatric procedures for weight loss and for selective metabolic diseases [14], [15], [16]. Despite these advantages, they are technically demanding operations with greater concerns for malnutrition, diarrhea, and other adverse consequences, particularly if patients are lost to follow up [17].
This is the first paper which compares the outcomes of the classic Roux-en-Y version of DS (BPD-DS) to single anastomosis version of DS (SIPS). Our results demonstrate
Conclusion
The SIPS is a simplified DS procedure that is safe and has significantly shorter operative time, shorter length of stay, and fewer perioperative and postoperative complications than BPD-DS. However, weight loss was more with BPD-DS. A fair criticism is that the vast majority of BPD-DS cases were done before the SIPS cases. As a result, experience and learning curve cannot be completely dismissed when viewing postoperative complications. The SIPS offers the patients the opportunity to take any
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
References (30)
- et al.
Comparison of effects of gastric bypass and biliopancreatic diversion with duodenal switch on weight loss and body composition 1-2 years after surgery
Surg Obes Relat Dis
(2007) - et al.
Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients
Surg Obes Rel Dis
(2013) - et al.
A safer and simpler technique of duodenal dissection and transection of the duodenal bulb for duodenal switch
Surg Obes Relat Dis
(2016) - et al.
Retrograde filling of the afferent limb as a cause of chronic nausea after single anastomosis loop duodenal switch
Surg Obes Relat Dis
(2016) - et al.
Biliopancreatic diversion for obesity; state of the art
Surg Obes Relat Dis
(2005) - et al.
Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up
Surg Obes Relat Dis
(2015) - et al.
Duodenal switch versus Roux-en-Y gastric bypass for morbid obesity: systematic review and meta-analysis of weight results, diabetes resolution and early complications in single-centre comparisons
Obes Rev
(2014) - et al.
Comparison of Vertical Sleeve Gastrectomy Versus Biliopancreatic Diversion
N Am J Med Sci
(2014) - et al.
Duodenal switch provides superior weight loss in the super-obese (BMI≥50 kg/m2) compared with gastric bypass
Ann Surg
(2006) - et al.
Comparative analysis of vertical banded gastroplasty and duodenal switch at five yeats follow-up
Obes Surg
(2005)
Biliopancreatic diversion: the effectiveness of duodenal switch and its limitations
Gastroenterol Res Pract
Biliopancreatic diversion with a duodenal switch
Obes Surg
Biliopancreatic diversion with a new type of gastrectomy
Obes Surg
Stomach intestinal pylorus sparing surgery (SIPS) with laparoscopic fundoplication (LF): a new approach to gastroesophageal reflux disease (GERD) in the setting of morbid obesity
SpringerPlus
Proximal duodenal–ileal end-to-side bypass with sleeve gastrectomy: proposed technique
Obes Surg
Cited by (58)
Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): short-term outcomes from a prospective cohort study
2021, Surgery for Obesity and Related DiseasesCitation Excerpt :The median BMIs before SG were similar among both procedures, at >60 kg/m2, and by the end of the follow-up, both procedures yielded an added 14–17 kg in TWL as second-stage procedures and an overall 21-unit drop in BMI. While this study reports only short-term follow-ups (median of 1–1.5 yr after surgery), our observed weight loss outcomes are comparable with those reported at medium-term follow-ups in other studies for both SADI-S and classic DS procedures [15,19–21]. Moreover, in a recent, large, single-center, retrospective cohort study by Finno et al. [15], the authors observed that while the amounts of weight loss seen after SADI-S and DS were comparable up to 2 years after surgery, the DS procedure achieved a better BMI reduction for those with BMIs > 55 kg/m2, albeit only by a mean of a 2.6-unit difference.
Single and dual anastomosis duodenal switch for obesity treatment: a single-center experience
2021, Surgery for Obesity and Related DiseasesLong-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S)
2020, Surgery for Obesity and Related Diseases