Four-Year Nutritional Outcomes in Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Patients: an Australian Experience

Abstract

Nutritional deficiencies following malabsorptive surgeries are a major concern. Purpose To present clinical-based, mid-term nutritional outcomes in single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) patients using a nutritional supplement based on the American Society for Metabolic & Bariatric Surgery (ASMBS) guidelines. Setting Single private institute, Australia. Materials and Methods Data from 196 patients who underwent a primary SADI-S by a single surgeon from January 2017 through March 2022 were retrospectively analysed. All patients received either original or altered formulated nutritional supplementation throughout the study. In total, three formulae, slightly different from each other, were used at three different time points to formulate the supplement. Results In total, 196 patients were included. The average age and preoperative body mass index were 44.9 ± 6.7 years and 43.6 ± 22.5 kg/m2, respectively. Nutritional follow-up was available on 77.5%, 73.2%, 73.4%, and 59.7% of patients at 12, 24, 36, and 48 months, respectively. At baseline, 48.3%, 30%, 14.9%, 13.3%, 12.4%, 3.8%, 2.3%, and 0.5% of the patients had vitamin D, calcium, folic acid, total protein, iron, vitamin B12, copper, and vitamin A deficiencies, respectively. Postoperatively, mild to moderate vitamin deficiencies were noted in 14.2% of the patients in the first 18 months; however, at 4 years, the cohort had zero nutritional deficiencies. There were no long-term complications, revisions/conversions, or mortalities related to nutritional deficiencies. Conclusion Factors, like preoperative and postoperative early, aggressive correction of nutritional deficiencies, regular laboratory monitoring and follow-ups with the multidisciplinary team, and adherence to our formulated nutritional supplement, have contributed to favourable nutritional outcomes at 4 years. Graphical Abstract

Evaluation study of single-anastomosis duodenal-ileal bypass with sleeve gastrectomy in the treatment of Chinese obese patients based on efficacy and nutrition

“…Furthermore, we found that vit A and vit E deficiencies were the most common nutrient deficiencies, with an incidence rate of 45.5 and 25.8%, respectively. Interestingly, Rao et al 39 reported that the nutrient deficiency rate was 0% after 4 years of SADI-S surgery. This may be because the postoperative follow-up rate was high and nutrients were monitored and supplemented in time.…”

Challenges of Revisional Metabolic and Bariatric Surgery: A Comprehensive Guide to Unraveling the Complexities and Solutions of Revisional Bariatric Procedures

“…Numerous studies have described malabsorption as the predominant complication following SADI-S and DS interventions, resulting in consequential malnutrition, with prevalence rates ranging from 2% to 18.5% [ 117 , 118 , 119 ]. However, recent studies have identified GERD as a post-procedural side effect following SADI-S and DS [ 120 , 121 , 122 , 123 , 124 ].…”