IBC-Oxford University2023_BJSPoster_14Short-Term Outcomes of Single-Anastomosis Sleeve-Ileal Bypass (SASI)

Abstract

Abstract Background The SASI bypass, which is a simplified version of sleeve gastrectomy with transit bipartition, is based on the same metabolic principles, particularly the early postprandial ileal brake. Compared to SASI bypass, sleeve gastrectomy offers advantages such as shorter operation time and lower incidence of internal herniation. The aim of this study was to assess the safety and outcomes of SASI bypass over a 3-year follow-up period. Methods A retrospective study was conducted on all patients who underwent SASI bypass between January 2018 and June 2023. The primary endpoints were weight loss and diabetic remission. Results A total of 54 patients, with a mean age of 39,4 ± 15 years and a mean body mass index of 38,5 ± 6,8 kg/m2, underwent SASI bypass. There was no significant early postoperative complications. At the end of the first year, the average percentage of excess weight loss (%EWL) was 82,6 ± 7,4, and the rate of diabetic remission was 96,1 %. After 3 years, the %EWL was 97,4 ± 4,1, and the diabetic remission rate was 98,8%. Severe protein-energy malnutrition occurred in 4 patients(7,4%), and reversal of the bypass were made in 3 of 4 patients. Technical variations did not significantly affect %EWL or diabetic remission. Conclusion SASI bypass demonstrated promising outcomes in terms of 3-year %EWL and diabetic remission. While the double-outlet for gastric content allows access to the duodenum, it may hinder the standardization of postoperative care. Furthermore, the presence of a double-outlet does not guarantee the absence of malnutrition.