A Prospective Randomized Trial Comparing Single Anastomosis Dudenoileal Bypass Versus Single Anastomosis Gastroileal Bypass After Failed Laparoscopic Sleeve Gastrectomy

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Background: The reported revision rate after sleeve gastrectomy (SG) is ~28–37% at 5–7 years. The most commonreason for revision is unsatisfactory weight loss (WL) or weight regain. There are various surgical options availablefor revision after a failed primary SG. However, it is important to identify the most optimal revisional procedure foreach patient. We aimed to compare between single anastomosis dudenoileal bypass (SADI) versus single anastomosisgastroileal bypass (SAGI-OAGB) as a revision surgery for weight regain after failed SG focusing on WL, resolution ofcomorbidities, and postoperative parameters.Patients and Methods: This prospective randomized study was conducted on 30 patients with failed laparoscopic SGto compare between SADI versus SAGI as a revision surgery for failed SG. Patients were divided into two equal groups:group Ӏ patients were subjected to laparoscopic (SAGI-OAGB) with a fixed common limb 3 M from the ileocecal valve,and group II patients were subjected to laparoscopic SADI with a fixed common limb 3 M from the ileocecal valve.Results: Group II exhibited a statistically significant difference from group I concerning excess WL, a lower meanhemoglobin A1c, and a longer mean length of hospital stay. Regarding the identified unfavorable outcomes, there wasinsignificant difference between the groups under study.Conclusion: The interventions applied in group II, which likely had a more significant impact on WL and glycemiccontrol, were accompanied by better outcomes compared with the interventions in group I.

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