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Comparison of the Outcomes of Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S), Single Anastomosis Sleeve Ileal (SASI) Bypass with Sleeve Gastrectomy, and Sleeve Gastrectomy Using a Rodent Model with Diabetes

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Abstract

Objective

Single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) is a powerful form of bariatric surgery; however, it has a high risk of malnutrition. Single anastomosis sleeve ileal (SASI) bypass with sleeve gastrectomy may be used as an alternative procedure to avoid malnutrition associated with SADI-S; however, no comparison between the two procedures has been performed.

Methods

Sprague–Dawley rats with diabetes (n = 32) were divided into four groups: SADI-S (n = 8), SASI (n = 8), SG (n = 8), and SHAM (n = 8). Body weight, food intake, and fasting blood glucose were measured, and the oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were performed before and after surgery. Blood samples were collected before and after the surgery to assess the levels of glucagon-like peptide-1 (GLP-1), hemoglobin, albumin, vitamin B12, calcium, and iron.

Results

The SADI-S and SASI groups showed significantly greater weight loss and better glucose control than the SG group postoperatively. The SADI-S and SASI groups showed similar improvements in glucose control throughout the study. The SADI-S and SASI groups had significantly higher GLP-1 levels than the SG group at 6 months. The SADI-S and SASI groups presented with various degrees of deficiencies, with the SADI-S group showing a higher risk for hypoalbuminemia and iron deficiency than the SASI group.

Conclusions

The SASI procedure may be a better alternative as it has excellent bariatric and metabolic results with lower risk for hypoalbuminemia and can be easily converted into either SADI-S or SG procedures. Nevertheless, further clinical results are needed.

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Funding

This study was supported by the Science and Technology Program Project of Xuzhou (KC19157).

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Authors and Affiliations

  1. Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People’s Republic of China

    Wei Wu, Jason Widjaja, Sheng Lu, Jian Hong, Libin Yao & Xiaocheng Zhu

Authors
  1. Wei Wu
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  2. Jason Widjaja
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  3. Sheng Lu
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  4. Jian Hong
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  5. Libin Yao
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  6. Xiaocheng Zhu
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Corresponding author

Correspondence to Xiaocheng Zhu.

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Conflict of Interest

The authors declare no competing interests.

Statement of Animal Right

All applicable institutional and national guidelines of the People’s Republic of China for the care and use of animals were followed.

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Jason Widjaja and Wei Wu contributed equally to this work.

Highlights

• The SADI-S and SASI procedures showed significantly better glucose control than the SG procedure.

• The SADI-S and SASI procedures showed similar improvements in glucose control.

• The SASI procedure has a lower risk of hypoalbuminemia and iron deficiency than the SADI-S procedure throughout the study.

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Wu, W., Widjaja, J., Lu, S. et al. Comparison of the Outcomes of Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S), Single Anastomosis Sleeve Ileal (SASI) Bypass with Sleeve Gastrectomy, and Sleeve Gastrectomy Using a Rodent Model with Diabetes. OBES SURG 32, 1209–1215 (2022). https://doi.org/10.1007/s11695-022-05920-5

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  • DOI: https://doi.org/10.1007/s11695-022-05920-5

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