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Roux-en-Y Gastric Bypass with Long Biliopancreatic Limb Compared to Single Anastomosis Sleeve Ileal (SASI) Bypass in Treatment of Morbid Obesity

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Abstract

Purpose

Bariatric surgery is the most effective treatment of morbid obesity. Bariatric procedures employ different mechanisms of action to induce weight loss. The present study aimed to compare single-anastomosis sleeve ileal (SASI) bypass and roux-en-Y gastric bypass RYGB with long biliopancreatic limb (BPL) in terms of weight loss, remission of comorbidities, complications, and nutritional status.

Methods

This was a single-center cohort study on patients with morbid obesity who underwent RYGB with long BPL of 150 cm or SASI bypass. The main outcome measures were weight loss and improvement in comorbidities at 12 months, nutritional status, and complications.

Results

The present study included 92 patients (59.8% females) of a mean age of 38.4 years and mean BMI of 42 kg/m2. RYGB and SASI bypass were followed by a significant decrease in body mass index at 12 months and were comparable in terms of excess and total weight loss. Improvement in comorbidities after the two procedures was similar. The serum albumin levels showed a significant decline after RYGB, but not after SASI bypass. The postoperative serum iron levels were higher after SASI bypass than after RYGB. There was no significant difference in regard to complication rates (13% vs 4.3%, p = 0.27).

Conclusions

RYGB with long BPL and SASI bypass achieved satisfactory weight loss and improvement in comorbidities that were comparable among the two groups. Long BPL RYGB was followed by a significant decrease in serum albumin and iron levels at one year, which was not observed after SASI bypass.

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Authors and Affiliations

  1. General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt

    Tarek Mahdy, Sameh Hany Emile, Waleed Gado & Amr Madyan

  2. University Hospital Sharjah, Sharjah, United Arab Emirates

    Tarek Mahdy

  3. Al-Qassimi Hospital, Ministry of Health and Prevention (MOHAP), Sharjah, United Arab Emirates

    Abdulwahid Alwahedi

  4. Aker University Hospital, Oslo University, Oslo, Norway

    Carl Schou

Authors
  1. Tarek Mahdy
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  2. Sameh Hany Emile
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  3. Abdulwahid Alwahedi
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  4. Waleed Gado
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  5. Carl Schou
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  6. Amr Madyan
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Contributions

Tarek Mahdy and Sameh Emile designed the study, participated in data collection and analysis, writing and revision of the manuscript. Abdulwahid Alwahedi, Waleed Gado and Carl Schou contributed to data interpretation, drafting, and critical revision of the final manuscript. Amr Madyan shared in data analysis and writing of the manuscript.

Corresponding author

Correspondence to Sameh Hany Emile.

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Ethics approval

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. Ethics approval for the study was obtained from the Research Ethics Committee.

Informed consent

Informed consent does not apply as for this type of study formal consent is not required.

Conflict of interest

The authors declare no competing interests.

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Key Points

• RYGB and SASI bypass were followed by a significant decrease in BMI and were comparable in terms of excess and total weight loss and improvement in comorbidities.

• The serum albumin levels showed a significant decline after RYGB, but not after SASI bypass.

• The postoperative serum iron levels were higher after SASI bypass than after RYGB.

• There was no significant difference in regards to complication rates.

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Mahdy, T., Emile, S.H., Alwahedi, A. et al. Roux-en-Y Gastric Bypass with Long Biliopancreatic Limb Compared to Single Anastomosis Sleeve Ileal (SASI) Bypass in Treatment of Morbid Obesity. OBES SURG 31, 3615–3622 (2021). https://doi.org/10.1007/s11695-021-05457-z

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  • DOI: https://doi.org/10.1007/s11695-021-05457-z

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