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Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy/One Anastomosis Duodenal Switch (SADI-S/OADS) IFSO Position Statement—Update 2020

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Preamble

The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has played an integral role in educating both the metabolic surgical and the medical communities at large about the role of innovative and new surgical and or endoscopic interventions in treating adiposity-based chronic diseases. The single anastomosis duodenal-ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) is a relatively new procedure that has been proposed as an alternative to the conventional duodenal switch (DS) procedure. The IFSO published a position paper on SADI-S/OADS in 2018 with which concluded that this procedure was likely to be a safe and efficacious treatment for adiposity and its related diseases. However, it noted that there was insufficient long-term data and minimal high-level evidence available. The position statement called for patients to be enrolled in long-term multidisciplinary care encouraged the registration of patients in national registries, and called for more randomized controlled trials (RCT) (Obes Surg 28:1207–16, 2018) involving the procedure. The following position statement is an update of the previous position statement. It is issued by the IFSO SADI-S/OADS task force and has been reviewed and approved by both the IFSO Scientific Committee and Executive Board. This statement is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence. It will be reviewed again in 2 years.

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References

  1. DeMeester TR, Fuchs KH, Ball CS, et al. Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. Ann Surg. 1987;206:414–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Traverso LW, Longmire Jr WP. Preservation of the pylorus in pancreaticoduodenectomy. Surg Gynecol Obstet. 1978;146:959–62.

    CAS  PubMed  Google Scholar 

  3. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8:267–82.

    Article  CAS  PubMed  Google Scholar 

  4. Marceau P, Biron S, St Georges R, et al. Biliopancreatic diversion with gastrectomy as surgical treatment of morbid obesity. Obes Surg. 1991;1:381–7.

    Article  CAS  PubMed  Google Scholar 

  5. O'Brien P, McPhail T, Chaston T, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.

    Article  PubMed  Google Scholar 

  6. Marceau P, Biron S, Marceau S, et al. Long-term metabolic outcomes 5 to 20 years after biliopancreatic diversion. Obes Surg. 2015;25:1584–93.

    Article  PubMed  Google Scholar 

  7. Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.

    Article  PubMed  Google Scholar 

  8. Sanchez-Pernaute A, Rubio Herrera MA, Perez-Aguirre E, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17:1614–8.

    Article  PubMed  Google Scholar 

  9. Mitzman B, Cottam D, Goriparthi R, et al. Stomach intestinal pylorus sparing (SIPS) surgery for morbid obesity: retrospective analyses of our preliminary experience. Obes Surg. 2016;26:2098–104.

    Article  PubMed  Google Scholar 

  10. Lee WJ, Lee KT, Kasama K, et al. Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): short-term result and comparison with gastric bypass. Obes Surg. 2014;24:109–13.

    Article  PubMed  Google Scholar 

  11. Huang CK, Goel R, Tai CM, et al. Novel metabolic surgery for type II diabetes mellitus: loop duodenojejunal bypass with sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2013;23:481–5.

    Article  PubMed  Google Scholar 

  12. Karcz WK, Kuesters S, Marjanovic G, et al. Duodeno-enteral omega switches - more physiological techniques in metabolic surgery. Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques. 2013;8:273–9.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Brown WA, Ooi G, Higa K, et al. Single anastomosis duodenal-ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) IFSO position statement. Obes Surg. 2018;28:1207–16.

    Article  PubMed  Google Scholar 

  14. Kim J. American Society for Metabolic and Bariatric Surgery statement on single-anastomosis duodenal switch. Surg Obes Relat Dis. 2016;12:944–5.

    Article  PubMed  Google Scholar 

  15. Kallies K, Rogers AM. American Society for Metabolic and Bariatric Surgery updated statement on single-anastomosis duodenal switch. Surg Obes Relat Dis. 2020;16:825–30.

    Article  PubMed  Google Scholar 

  16. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2018. at http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

  17. Nelson L, Moon RC, Teixeira AF, et al. Safety and effectiveness of single anastomosis duodenal switch procedure: Preliminary results from a single institution. Arq Bras Cir Dig. 2016;29(Suppl 1):80–4.

    Article  PubMed Central  Google Scholar 

  18. Surve A, Zaveri H, Cottam D, et al. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017;13:415–22.

    Article  PubMed  Google Scholar 

  19. Cottam A, Cottam D, Medlin W, et al. A matched cohort analysis of single anastomosis loop duodenal switch versus roux-en-Y gastric bypass with 18-month follow-up. Surg Endosc Other Interv Tech. 2016a;30:3958–64.

    Article  Google Scholar 

  20. Grueneberger JM, Karcz-Socha I, Marjanovic G, et al. Pylorus preserving loop duodeno-enterostomy with sleeve gastrectomy - preliminary results. BMC Surg. 2014;14:20.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Huang CK, Tai CM, Chang PC, et al. Loop duodenojejunal bypass with sleeve gastrectomy: comparative study with Roux-en-Y gastric bypass in type 2 diabetic patients with a BMI <35 kg/m2, First Year Results. Obes Surg. 2016;26:2291–301.

    Article  PubMed  Google Scholar 

  22. Lee WJ, Almulaifi AM, Tsou JJ, et al. Duodenal-jejunal bypass with sleeve gastrectomy versus the sleeve gastrectomy procedure alone: the role of duodenal exclusion. Surg Obes Relat Dis. 2015;11:765–70.

    Article  PubMed  Google Scholar 

  23. Morales H, Berger F, Espinoza M, et al. Gastrectomia vertical y derivacion duodeno-ileal de anastomosis unica termino-lateral en bariatria: experiencia en 100 casos [Spanish]. Bariatrica e Metabolica Iberoamericana. 2012;2:76–80.

    Google Scholar 

  24. Sanchez-Pernaute A, Herrera MAR, Perez-Aguirre ME, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20:1720–6.

    Article  PubMed  Google Scholar 

  25. Sanchez-Pernaute A, Rubio MA, Perez Aguirre E, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis. 2013;9:731–5.

    Article  PubMed  Google Scholar 

  26. Sanchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015a;11:351–5.

    Article  PubMed  Google Scholar 

  27. Sanchez-Pernaute A, Rubio MA, Cabrerizo L, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015b;11:1092–8.

    Article  PubMed  Google Scholar 

  28. Balibrea JM, Vilallonga R, Hidalgo M, et al. Mid-term results and responsiveness predictors after two-step single-anastomosis duodeno-ileal bypass with sleeve gastrectomy. Obes Surg. 2017;27:1302–8.

    Article  PubMed  Google Scholar 

  29. Cottam A, Cottam D, Portenier D, et al. A matched cohort analysis of stomach intestinal pylorus saving (SIPS) surgery versus biliopancreatic diversion with duodenal switch with two-year follow-up. Obes Surg. 2017;27:454–61.

    Article  PubMed  Google Scholar 

  30. Cottam A, Cottam D, Roslin M, et al. A matched cohort analysis of sleeve gastrectomy with and without 300 cm loop duodenal switch with 18-month follow-up. Obes Surg. 2016b;26:2363–9.

    Article  PubMed  Google Scholar 

  31. Ramos-Levi AM, Sanchez-Pernaute A, Marcuello C, et al. Glucose variability after bariatric surgery: is prediction of diabetes remission possible? Obes Surg. 2017;27:3341–3.

    Article  PubMed  Google Scholar 

  32. Moon RC, Gaskins L, Teixeira AF, et al. Safety and effectiveness of single-anastomosis duodenal switch procedure: 2-year result from a single US institution. Obes Surg. 2018;28:1571–7.

    Article  PubMed  Google Scholar 

  33. Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution. Surg Obes Relat Dis. 2019;15:245–52.

    Article  PubMed  Google Scholar 

  34. Wu A, Tian J, Cao L, et al. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) as a revisional surgery. Surg Obes Relat Dis. 2018;14:1686–90.

    Article  PubMed  Google Scholar 

  35. Dijkhorst PJ, Boerboom AB, Janssen IMC, et al. Failed sleeve gastrectomy: single anastomosis duodenoileal bypass or roux-en-Y gastric bypass? A multicenter cohort study. Obes Surg. 2018;28:3834–42.

    Article  PubMed  PubMed Central  Google Scholar 

  36. 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. 2018;28:2894–902.

    Article  PubMed  Google Scholar 

  37. Neichoy BT, Schniederjan B, Cottam DR, et al. Stomach intestinal pylorus-sparing surgery for morbid obesity. JSLS. 2018;22:e2017.00063.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ceha CMM, van Wezenbeek MR, Versteegden DPA, et al. Matched short-term results of SADI versus GBP after sleeve gastrectomy. Obes Surg. 2018;28:3809–14.

    Article  CAS  PubMed  Google Scholar 

  39. Zaveri H, Surve A, Cottam D, et al. Mid-term 4-year outcomes with single anastomosis duodenal-ileal bypass with sleeve gastrectomy surgery at a single US Center. Obes Surg. 2018;28:3062–72.

    Article  PubMed  Google Scholar 

  40. Surve A, Cottam D, Sanchez-Pernaute A, et al. The incidence of complications associated with loop duodeno-ileostomy after single-anastomosis duodenal switch procedures among 1328 patients: a multicenter experience. Surg Obes Relat Dis. 2018;14:594–601.

    Article  PubMed  Google Scholar 

  41. Pereira SS, Guimaraes M, Almeida R, et al. Biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) result in distinct post-prandial hormone profiles. Int J Obes. 2019;43:2518–27.

    Article  CAS  Google Scholar 

  42. Moon RC, Alkhairi L, Wier AJ, et al. Conversions of Roux-en-Y gastric bypass to duodenal switch (SADI-S and BPD-DS) for weight regain. Surg Endosc. 2019;

  43. Moon RC, Fuentes AS, Teixeira AF, et al. Conversions after sleeve gastrectomy for weight regain: to single and double anastomosis duodenal switch and gastric bypass at a single institution. Obes Surg. 2019;29:48–53.

    Article  PubMed  Google Scholar 

  44. Zaveri H, Surve A, Cottam D, et al. A multi-institutional study on the mid-term outcomes of single anastomosis duodeno-ileal bypass as a surgical revision option after sleeve Gastrectomy. Obes Surg. 2019;29:3165–73.

    Article  PubMed  Google Scholar 

  45. Pearlstein S, Sabrudin SA, Shayesteh A, et al. Outcomes after laparoscopic conversion of failed adjustable gastric banding (LAGB) to laparoscopic sleeve gastrectomy (LSG) or single anastomosis duodenal switch (SADS). Obes Surg. 2019;29:1726–33.

    Article  PubMed  Google Scholar 

  46. Enochs P, Bull J, Surve A, et al. Comparative analysis of the single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures: an assessment of 2-year postoperative data illustrating weight loss, type 2 diabetes, and nutritional status in a single US center. Surg Obes Relat Dis. 2020;16:24–33.

    Article  PubMed  Google Scholar 

  47. Cottam D, Roslin M, Enochs P, et al. Single anastomosis duodenal switch: 1-year outcomes. Obes Surg. 2020;30:1506–14.

    Article  PubMed  Google Scholar 

  48. Surve A, Rao RV, Cottam D, et al. Early outcomes of primary SADI-S: an Australian experience. Obes Surg. 2020;30:1429–36.

    Article  PubMed  Google Scholar 

  49. Finno P, Osorio J, Garcia-Ruiz-de-Gordejuela A, et al. Single versus double-anastomosis duodenal switch: single-site comparative cohort study in 440 consecutive patients. Obes Surg. 2020;8

  50. Ruan X, Zhang W, Cai H, et al. Sleeve gastrectomy with duodenojejunal end-to-side anastomosis in the treatment of type 2 diabetes: the initial experiences in a Chinese population with a more than 4-year follow-up. Surg Obes Relat Dis. 2017;13:1683–91.

    Article  PubMed  Google Scholar 

  51. Ser KH, Lee WJ, Chen JC, et al. Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): surgical risk and long-term results. Surg Obes Relat Dis. 2019;15:236–43.

    Article  PubMed  Google Scholar 

  52. Li YX, Fang DH, Liu TX. Laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass in the treatment of type 2 diabetes mellitus of patients with body mass index higher than 27.5 kg/m2 but lower than 32.5 kg/m2. Medicine. 2018;97:e11537.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Hanipah ZN, Hsin MC, Liu CC, et al. Laparoscopic loop duodenaljejunal bypass with sleeve gastrectomy in type 2 diabetic patients. Surg Obes Relat Dis. 2019;15:696–702.

    Article  Google Scholar 

  54. Lin S, Yang N, Guan W, et al. Can Chinese T2D patients with BMI 20-32.5 kg/m(2) benefit from loop duodenojejunal bypass with sleeve gastrectomy? Surg Obes Relat Dis. 2019;15:1513–9.

    Article  PubMed  Google Scholar 

  55. Sessa L, Guidone C, Gallucci P, et al. Effect of single anastomosis duodenal-ileal bypass with sleeve gastrectomy on glucose tolerance test: comparison with other bariatric procedures. Surg Obes Relat Dis. 2019;15:1091–7.

    Article  PubMed  Google Scholar 

  56. Huang CK, Wang MY, Das SS, et al. Laparoscopic conversion to loop duodenojejunal bypass with sleeve gastrectomy for intractable dumping syndrome after roux-en-Y gastric bypass-two case reports. Obes Surg. 2015;25:947.

    Article  PubMed  Google Scholar 

  57. Summerhays C, Cottam D, Cottam A. Internal hernia after revisional laparoscopic loop duodenal switch surgery. Surg Obes Relat Dis. 2016;12:e13–5.

    Article  PubMed  Google Scholar 

  58. Vilallonga R, Fort JM, Caubet E, et al. Robotically assisted single anastomosis duodenoileal bypass after previous sleeve gastrectomy implementing high valuable technology for complex procedures. J Obes. 2015;2015:586419.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Chiappetta S, Stier C, Scheffel O, et al. The first case report of failed single-anastomosis-duodeno-ileal bypass converted to one anastomosis gastric bypass/mini-gastric bypass. Int J Surg Case Rep. 2017;35:68–72.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Tsai YN, Wang HP, Huang CK, et al. Endoluminal stenting for the management of leak following sleeve gastrectomy and loop duodenojejunal bypass with sleeve gastrectomy. Kaohsiung J Med Sci. 2018;34:43–8.

    Article  PubMed  Google Scholar 

  61. Vilallonga R, Balibrea JM, Curell A, et al. Technical options for malabsorption issues after single anastomosis duodenoileal bypass with sleeve gastrectomy. Obes Surg. 2017;27:3344–8.

    Article  PubMed  Google Scholar 

  62. Kirkpatrick V, Moon RC, Teixeira AF, et al. Cirrhosis following single anastomosis duodeno-ileal switch: a case report. Int J Surg Case Rep. 2018;45:130–2.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to acknowledge and thank both the Scientific Committee of IFSO and the Executive Board of IFSO for their expert review and advice.

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Authors and Affiliations

  1. International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy

    Wendy A. Brown, Guillermo Ponce de Leon Ballesteros, Geraldine Ooi, Kelvin Higa, Jacques Himpens, Antonio Torres, Scott Shikora, Lilian Kow & Miguel F. Herrera

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  1. Wendy A. Brown
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  2. Guillermo Ponce de Leon Ballesteros
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  3. Geraldine Ooi
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Consortia

on behalf of the IFSO appointed task force reviewing the literature on SADI-S/OADS

Corresponding author

Correspondence to Wendy A. Brown.

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Conflict of Interest

Dr. Wendy Brown reports grants from Johnson and Johnson, grants from Medtronic, grants from GORE, personal fees from GORE, grants from Applied Medical, grants from Apollo Endosurgery, grants and personal fees from Novo Nordisc, and personal fees from Merck Sharpe and Dohme, outside the submitted work.

Guillermo Ponce de Leon Ballesteros reports no conflicts of interest.

Dr. Geraldine Ooi reports no conflicts of interest.

Dr. Kelvin Higa reports no conflicts of interest.

Dr. Jacques Himpens is a consultant with Medtronic and Johnson and Johnson.

Dr. Antonio Torres reports no conflicts of interest.

Dr. Scott Shikora reports no conflicts of interest.

Dr. Lilian Kow reports no conflicts of interest.

Miguel F. Herrera reports no conflicts of interest.

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Appendices

Appendix 1. Members of the IFSO-appointed task force reviewing the literature on SADI-DS/OADS

Geraldine Ooi–Australia.

Wendy Brown–Australia.

Lilian Kow–Australia.

Antonio Torres–Spain.

Jacques Himpens–Belgium.

Miguel Herrera–Mexico.

Guillermo Ponce de Leon Ballesteros–Mexico.

Scott Shikora–USA.

Kelvin Higa–USA.

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Brown, W.A., de Leon Ballesteros, G.P., Ooi, G. et al. Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy/One Anastomosis Duodenal Switch (SADI-S/OADS) IFSO Position Statement—Update 2020. OBES SURG 31, 3–25 (2021). https://doi.org/10.1007/s11695-020-05134-7

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