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Single Versus Double-Anastomosis Duodenal Switch: Single-Site Comparative Cohort Study in 440 Consecutive Patients

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Abstract

Purpose

To study weight loss, comorbidity remission, complications, and nutritional deficits after duodenal switch (DS) and single-anastomosis DS with sleeve gastrectomy (SADI-S).

Material and Methods

Retrospective review of patients submitted to DS or SADI-S for morbid obesity in a single university hospital.

Results

Four hundred forty patients underwent DS (n = 259) or SADI-S (n = 181). Mean preoperative body mass index (BMI) was 50.8 ± 6.4Kg/m2. Mean follow-up was 56.1 ± 37.2 months for DS and 27.2 ± 18.9 months for SADI-S. Global mean excess weight loss was 77.4% at 2 years similar for SADI-S and DS, and 72.1% at 10 years after DS. Although early complications were similar in SADI-S and DS (13.3% vs. 18.9%, p = n.s.), long-term complications and vitamin and micronutrient deficiencies were superior after DS. Rate of comorbidities remission was 85.2% for diabetes, 63.9% for hypertension, 77.6% for dyslipidemia, and 82.1% for sleep apnea, with no differences between both techniques. In patients with initial BMI > 55 kg/m2 (n = 91), DS achieved higher percentage of BMI < 35 kg/m2 (80% vs. 50%, p = 0.025) and higher rate of diabetes remission (100% vs. 75%, p = 0050).

Conclusions

DS and SADI-S showed similar weight loss and comorbidity remission rates at 2 years. In patients with initial BMI > 55 kg/m2, DS obtained better BMI control at 2 years and better diabetes remission, but more long-term complications and supplementation needs.

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Acknowledgements

The authors would like to thank Dr. Núria Vilarrasa and Dr. Fernando Guerrero, from the Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, for their contribution in patients’ preoperative circuit and follow-up, and Ana Aguilar for English language assistance.

Funding

There were no grants provided for this study.

Author information

Authors and Affiliations

  1. Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, FeixaLlarga s/n, L’Hospitalet de Llobregat, 08907, Barcelona, Spain

    Pablo Finno, Javier Osorio, Amador García-Ruiz-de-Gordejuela, Anna Casajoana, María Sorribas, Víctor Admella, Mónica Serrano & Jordi Pujol-Gebellí

  2. Marchesini Institute, Curitiba, Brazil

    Joao Batista Marchesini

  3. Gastro Obeso-Center-Advanced Institute in Bariatric and Metabolic Surgery, Sao Paulo, Brazil

    Almino C. Ramos

Authors
  1. Pablo Finno
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  2. Javier Osorio
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Corresponding author

Correspondence to Javier Osorio.

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This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study formal consent is not required.

Conflict of Interest

Pablo Finno, Javier Osorio, Amador García Ruiz de Gordejuela, Anna Casajoana, María Sorribas, Víctor Admella, Mónica Serrano, Joao Batista Marchesini, Almino C. Ramos, and Jordi Pujol Gebellí have no conflict of interest.

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Finno, P., Osorio, J., García-Ruiz-de-Gordejuela, A. et al. Single Versus Double-Anastomosis Duodenal Switch: Single-Site Comparative Cohort Study in 440 Consecutive Patients. OBES SURG 30, 3309–3316 (2020). https://doi.org/10.1007/s11695-020-04566-5

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