Gastric Bypass Reversal and Simultaneous Conversion to SADI-S for Weight Regain: Preliminary Results

Roux-en-Y gastric bypass (RYGB) is an effective operation to treat morbidly obese patients, but weight loss is not sustainable for most patients. Such as revision or conversion surgeries, an alternative has been a single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S). Thus, this study addresses the description, feasibility, and early results of converting RYGB to SADI-S for weight recovery. Twelve patients (92% female, 41 ? 9 years old) were followed for 6 to 38 months after conversion from RYGB to SADI-S. At 6 months, body mass index decreased from 41 ? 3.4 to 32 ? 4.3 Kg/m2, and excess body weight loss was 59 ? 20%. Six patients (50%) developed early complications (less than30 days): transient gastroparesis, leak and intra-abdominal abscess resolved conservatively, pulmonary embolism and 1 hemoperitoneum. The common channel was 250 cm in the first 5 cases, of which 4 had late complications including severe diarrhea, reflux or weakness/malnutrition and a greater decline in albumin than 7 cases with 300 cm common channel. There were no reoperations or deaths. We believe that the detailed description of this method can help others bariatric surgeons choose it for their patients with primary RYGB failure without significant nutritional deficiencies.