Impact of Laparoscopic Single Anastomosis Duodeno-ileal Bypass-sleeve Gastrectomy versus Laparoscopic Sleeve Gastrectomy on Blood Sugar Control, OR Time and LOS

Abstract

Background: The loop duodenal switch is a risky procedure that requires patients to adopt a for life vitamin and protein supplement regime in order to avoid malnutrition. For that reason, we only advice  it for patients who can be very consistent taking multiple vitamins and protein supplements every day for the rest of their lives SADI-S benefits over DS included reduction of the operative risk by eliminating one anastomosis with potentially similar weight loss and health benefits. Purpose to asses blood sugar control between the two procedures in addition to OR time and LOS. 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] among them 8 were diabetics. Group B: 18 patients assigned for Sleeve Gastrectomy among them 3 were diabetics. Methods: To group A after doing the sleeve gastrectomy in the usual way the duodenum is anastomosed to a loop of ileum while in group B only sleeve is done. Results: Eight patients (44.4%) of SADI-S group were diabetic (T2DM), all of them were on oral hypoglycemic drugs. Diabetic control was achieved in 100% of them; with 8 cases (100%) reached complete remission which was significant higher than Sleeve gastrectomy group. There was an improvement regarding the postoperative levels of HbA1c in both groups with no statistically significant difference between them. Conclusion: SADI-S/OADS is more effective than LSG regarding blood sugar control with more operative time and longer hospital stay.