Post Laparoscopic Single Anastomosis Duodeno-ileal Bypass-Sleeve Gastrectomy Diarrhea versus Post Laparoscopic Sleeve Gastrectomy Diarrhea

Background: In a trial to modify the effective Biliopancreatic diversion – Doudenal switch (BPD-DS) operation - the same way Rutledge modified Roux en Y gastric bypass (RYGB) by doing one loop end-to-side anastomosis – and to preserve its principles, the single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was first described in 2007 by Sánchez-Pernaute and Torres as they performed Sleeve gastrectomy followed by 1-loop duodenoileostomy, with 250 cm between anastomosis and ileocecal valve. Anastomosis performed in antecolic and isoperistaltic manner. Diarrhea after bariatric surgery, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is not uncommon and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric procedures are the only sustainably successful method to address BMI and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Purpose to assess diarrhea after the two procedures.

Patients and Methods: The interventions were led at Beni-suef University Hospital between January 2018 and December 2019, after the patients fitted both the inclusions and exclusions criteria. This study consisted 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.

Results: Diarrhea was more evident in SADI group of patient at 6, 12 months.

Conclusion: SADI-S/OADS is associated with more diarrhea than LSG.