Effect of Laparoscopic Single Anastomosis Duodeno-ileal Bypass-Sleeve Gastrectomy versus Laparoscopic Sleeve Gastrectomy on Hypertension Hyperlipidemia and LDH-Cholesterol

Abstract

Background: Reports on outcomes of LSG with patients followed for more than 15 years are evolving—a fact that will produce long-term efficacy SADI-S was started in 2007 as a shorter, safer and equally effective modified version of biliopancreatic diversion with duodenal switch]. As the name suggests, SADI-S combines two bariatric procedures – LSG and duodeno-ileal bypass. This makes it a first option for patients after ineffective sleeve gastrectomy. In an attempt to simplify the effective BPD-DS procedure- the same way Rutledge simplified RYGB by doing one loop end-to-side anastomosis – and to preserve its principles, the single an astomos is duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was first introduced in 2007 by Sánchez-Pernaute and Torres as they did Sleeve gastrectomy followed by 1-loop duodenoileostomy, with 250 cm between an astomos is and ileocecal valve. Anastomosis performed in antecolic and isoperistaltic manner. Purpose to assess the effect of Laparoscopic Single Anastomosis Duodeno-ileal bypass-Sleeve Gastrectomy versus Laparoscopic Sleeve Gastrectomy on hypertension hyperlipidemia LDH and cholesterol. In addition to operative time (OR) and long of stay (LOS) in days. 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 of 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: Four patients (22.2%) were suffering from HTN in SADI-S group and 3(16.7%) hypertensive patients in Sleeve gastrectomy group. At 12 months postoperative, only one patient in sleeve group needed low dose of anti-hypertensive drug to have their BP controlled. Conclusion: Single Anastomosis Duodeno-ileal bypass – Sleeve Gastrectomy (SADI-S) is more effective than laparoscopic sleeve gastrectomy (LSG) regarding controlling blood pressure and hyperlipidemia also. SADI-Stook more operative time and longer hospital stay than LSG. There was an improvement regarding the postoperative levels of LDL-Cholesterol in both groups with no statistically significant difference between them. mostly due to small size of the study.