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Introduction <p>Single-anastomosis duodenoileal bypass (SADI) is an efficacious conversion operation to address suboptimal clinical response after sleeve gastrectomy (SG). Controversy remains regarding optimal length of the common channel for weight loss and potential adverse outcomes. The purpose of this study was to analyze conversion of SG to SADI, comparing 250&#xa0;cm (SADI-250) to 300&#xa0;cm (SADI-300) common channel length.</p> Methods <p>Data were collected from <i>n</i> = 63 patients (<i>n</i> = 40 SADI-250; <i>n</i> = 23 SADI-300) that underwent conversion of SG to SADI in a single metabolic and bariatric surgery center of excellence. The primary outcome was percent total weight loss (%TWL). Secondary outcomes were reoperations and nutrition-related complications.</p> Results <p>Three-year follow-up rates for SADI-250 patients were 90% (<i>n</i> = 36) and for SADI-300 were 91% (<i>n</i> = 21). Compared to SADI-300 patients, SADI-250 experienced greater %TWL throughout follow-up (<i>p</i> &lt; .001). SADI-250 patients continued to lose weight through three years; while SADI-300 patients began to regain weight at 12 months. At the end of three years, SADI-250 patients lost 15.1% more weight than SADI-300 patients. There were three reoperations, one for the SADI-300 and two for the SADI-250 and no significant nutritional complications in either group.</p> Conclusion <p>The SADI-250 operation was associated with significantly greater weight loss at three years compared to SADI-300, with no differences in complications between the two operations. Conversion of SG to SADI using a 250 cm common channel led to significant additional weight loss (25.7% TWL at three years).</p>

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Single-Anastomosis Duodenoileal Bypass Conversion for Sleeve Gastrectomy: Three-Year Outcomes Comparing 300 cm vs 250 cm Common Channel Length

  • 期刊论文

  • 发表日期：

    2026年7月21日

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  • Robert A. Casillas,
  • Eduardo Alvarez,
  • Adeel Ashfaq,
  • Jay J. Patel,
  • Jorge L. Zelada Getty,
  • Scott S. Um,
  • Michael L. Hibbard,
  • Karen J. Coleman

摘要

Introduction

Single-anastomosis duodenoileal bypass (SADI) is an efficacious conversion operation to address suboptimal clinical response after sleeve gastrectomy (SG). Controversy remains regarding optimal length of the common channel for weight loss and potential adverse outcomes. The purpose of this study was to analyze conversion of SG to SADI, comparing 250 cm (SADI-250) to 300 cm (SADI-300) common channel length.

Methods

Data were collected from n = 63 patients (n = 40 SADI-250; n = 23 SADI-300) that underwent conversion of SG to SADI in a single metabolic and bariatric surgery center of excellence. The primary outcome was percent total weight loss (%TWL). Secondary outcomes were reoperations and nutrition-related complications.

Results

Three-year follow-up rates for SADI-250 patients were 90% (n = 36) and for SADI-300 were 91% (n = 21). Compared to SADI-300 patients, SADI-250 experienced greater %TWL throughout follow-up (p < .001). SADI-250 patients continued to lose weight through three years; while SADI-300 patients began to regain weight at 12 months. At the end of three years, SADI-250 patients lost 15.1% more weight than SADI-300 patients. There were three reoperations, one for the SADI-300 and two for the SADI-250 and no significant nutritional complications in either group.

Conclusion

The SADI-250 operation was associated with significantly greater weight loss at three years compared to SADI-300, with no differences in complications between the two operations. Conversion of SG to SADI using a 250 cm common channel led to significant additional weight loss (25.7% TWL at three years).