Background

Background: Sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single-anastomosis duodenal-ileal bypass (SADI) are established bariatric procedures. There is limited long term data comparing these procedures. Objective: A retrospective review of long-term data on a cohort of patients undergoing SG, RYGB, or SADI-S to evaluate weight loss and HgbA1c level as well as compare the nutritional outcomes between RYGB and SADI.

Methods

A retrospective review of 878 patients who underwent SG, RYGB, or SADI from April 2014 - October 2015 by 5 surgeons in a single institution. For weight loss analysis, the patients were categorized into 4 different categories: patients regardless of their preoperative BMI, preoperative BMI <45 kg/m2, preoperative BMI 45 to 55 kg/m2, and preoperative BMI >55 kg/m2.

Results

A total of 878 patients were identified for analysis. Of 878 patients, 448 patients, 270 patients, and 160 patients underwent SG, RYGB, and SADI, respectively. Overall, the weight loss was highest with SADI-S, followed by RYGB and SG in all 4 categories. In addition, the weight loss was highest in patients with preoperative BMI <45 kg/m2and lowest in patients with preoperative BMI >55 kg/m2. Also, there were no statistically significant differences between the nutritional outcomes between RYGB and SADI-S. The SADI had significantly lower rates of abnormal glycosylated hemoglobin than RYGB and SG.

Conclusions

The weight loss outcomes and glycosylated hemoglobin rates were better with SADI-S than RYGB or SG. The nutritional outcomes between RYGB and SADI were similar.