Background

While the single anastomosis duodeno-ileal switch with sleeve gastrectomy (SADI-S) has shown promising results, revisions due to malnutrition or malabsorption are significant concerns. One surgical option that can be considered for revisional surgery after SADI-S is common channel limb lengthening. This study aimed to evaluate outcomes following common channel limb lengthening as a re-operation after SADI-S at a high-volume bariatric center of excellence.

Methods

A prospectively maintained data registry was retrospectively reviewed to identify all patients who underwent common channel limb lengthening following SADI-S at our institution from August 2016 to February 2023. Outcomes following common channel limb lengthening were analyzed.

Results

A total of 14 patients (10 females; 4 males) with a mean age of 48.7 years were included. Reasons for reoperation were malnutrition (n=10) and malabsorptive symptoms refractory to medical management (n=4). The mean original common channel length was 250.1 cm, and the mean operative time was 98.09 minutes. When compared to preoperative baseline values, albumin levels were significantly increased at 3 months (2.97 vs 3.68, p=0.02), 6 months (2.97 vs 3.87, p=0.02), and 12 months (2.97 vs 3.97, p=0.03) after re-operation. Moreover, patients sustained a significant reduction in their BMI (-15.6 kg/m2, p=0.01) and percent weight loss (29.8, p=0.01) for up to one year postoperatively following their revisional surgery when compared to their pre-bariatric surgery weights. No major complications were observed at the 30-day review following revisional surgery.

Conclusions

Common channel limb lengthening is a safe and effective revisional surgery following SADI-S.