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An Analysis of Mid-Term Complications, Weight Loss, and Type 2 Diabetes Resolution of Stomach Intestinal Pylorus-Sparing Surgery (SIPS) Versus Roux-En-Y Gastric Bypass (RYGB) with Three-Year Follow-Up

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Abstract

Background

For many years, the Roux-en-Y Gastric Bypass (RYGB) was considered a good balance of complications and weight loss. According to several short-term studies, single anastomosis duodenal switch or stomach intestinal pylorus sparing surgery (SIPS) offers similar weight loss to RYGB with fewer complications and better diabetes resolution. No one has substantiated mid-term complication and nutritional differences between these two procedures. This paper seeks to compare complication and nutritional outcomes between RYGB and SIPS.

Methods

A retrospective analysis of 798 patients who either had SIPS or RYGB from 2010 to 2016. Complications were gathered for each patient. Nutritional outcomes were measured for each group at 1, 2, and 3 years. Regression analysis was applied to interpolate each patient’s weight at 3, 6, 9, 12, 18, 24, and 36 months. These were then compared with t tests, Fisher’s exact tests, and chi-squared tests.

Results

RYGB and SIPS have statistically similar weight loss at 3, 6, 9, 12, and 36 months. They statistically differ at 18 and 24 months. At 36 months, there is a trend for weight loss difference. There were only statistical differences in nutritional outcomes between the two procedures with calcium at 1 and 3 years and vitamin D at 1 year. There were statistically significantly more long-term class IIIb-V complications, class I-IIIa complications, reoperations, ulcers, small bowel obstructions, nausea, and vomiting with the RYGB than the SIPS.

Conclusion

With comparable weight loss and nutritional outcomes, SIPS has fewer short- and long-term complications than RYGB and better type 2 diabetes resolution rates.

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Authors and Affiliations

  1. Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA

    Austin Cottam BS, Daniel Cottam MD, Hinali Zaveri MD, Samuel Cottam, Amit Surve MD, Walter Medlin MD & Christina Richards MD

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  1. Austin Cottam BS
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  2. Daniel Cottam MD
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  4. Samuel Cottam
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Corresponding author

Correspondence to Daniel Cottam MD.

Ethics declarations

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Since this is a retrospective study, formal consent is not required for this type of study.

Conflicts of Interest

Austin Cottam has no conflicts of interest to declare.

Daniel Cottam, the corresponding author, reports personal fees and other from Medtronic, outside the submitted work.

Hinali Zaveri has no conflicts of interest to declare.

Samuel Cottam has no conflicts of interest to declare.

Amit Surve has no conflicts of interest to declare.

Walter Medlin has no conflicts of interest to declare.

Christina Richards has no conflicts of interest to declare.

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Cottam, A., Cottam, D., Zaveri, H. et al. An Analysis of Mid-Term Complications, Weight Loss, and Type 2 Diabetes Resolution of Stomach Intestinal Pylorus-Sparing Surgery (SIPS) Versus Roux-En-Y Gastric Bypass (RYGB) with Three-Year Follow-Up. OBES SURG 28, 2894–2902 (2018). https://doi.org/10.1007/s11695-018-3309-6

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