Bariatric Times

ICCDS-1 2016

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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Page 11 of 32

November 2016 • Supplement B • Bariatric Times B11 FIRST INTERNATIONAL CONSENSUS CONFERENCE ON DUODENAL SWITCH glycated hemoglobin 7.9 percent (range: 5.4–13%). Seventy-two p ercent of diabetic patients had an initial glycated hemoglobin over 6.5 %. Mean preoperative C-peptide was 2.12 ng/mL (0.4–7 ng/mL) and mean preoperative homeostasis model a ssessment (HOMA) was 7.9 (0.66– 22.10). Fifty-seven percent of our patients had dyslipidemia, 27 percent had obstructive sleep apnea, and 57 percent had hypertension. Glycemia and HbA1c values normalized in the early postoperative periods, with 85 percent of the diabetic patients showing levels of HbA1c below six percent. 4 The overall conversion rate for malnutrition is 3.8 percent, but this fell to 2.3 percent for patients with a 250 cm common limb. When we analyze our experience comparing SADI-s with RYGB in patients with obesity (BMI >50kg/m 2 ), the percentage of patients failing to get an EWL greater than 50 percent at five years was 40 percent in RYGB patients and nine percent in SADI-s patients. We then investigated the results in patients with BMI less than 50kg/m 2 . We found that the percentage of patients failing to reach 50 percent EWL at five years was 25 percent in RYGB and six percent in SADI-s patients. Some authors equate this procedure to that of the mini-gastric bypass, which is incorrect. Although the stomach is larger than after the mini gastric bypass, the pylorus is still not preserved and hence the mini-bypass is prone to alkaline reflux. REFERENCES 1. Sánchez-Pernaute A, Rubio Herrera MA, Pérez-Aguirre E, García Pérez JC, Cabrerizo L, Díez Valladares L, Fernández C, Talavera P, Torres A. Proximal duodeno-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17:1614–1618. 2. Scopinaro N, Gianetta E, Civalleri D, Bonalumi U, Bachi V. Bilio- pancreatic bypass for obesity: II. Initial experience in man. Br J Surg. 1979;66:618–620. 3. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8:267–282. 4. Sánchez-Pernaute A, Rubio MA, Pérez Aguirre E, Barabash A, Cabrerizo L, Torres A. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis. 2013;9:731–735. F i g u r e 1 . S cheme of t he single- anast omosis duodeno-ileal bypass w it h sleeve gast rect omy (S A DI -s) t echnique. S leeve gast rect omy plus one loop duodenal sw it ch w it h a 250 common channel Figure 2. Excess weight loss percentage of the series of patients who underwent the SADI-s operation

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