IBC Oxford Oral Abstract 15 - Single anastomosis sleeve ileal bypass compared to one anastomosis gastric bypass for sleeve gastrectomy adult nonresponders—a retrospective study

Abstract Introduction Single Anastomosis Sleeve Ileal Bypass (SASI) is a Novel Metabolic/Bariatric Surgery operation based on Santoro’s bipartition operation. One Anastomosis Gastric Bypass (OAGB) or Minigastric Bypass (MGB)is a growing bariatric procedure that had been invented by Dr. Robert Rutledge and is considered now the third commonly performed procedure worldwide after laparoscopic sleeve gastrectomy and classical gastric bypass. Both SASI and OAGB can be offered for patients with weight regain after Sleeve gastrectomy. Sleeve gastrectomy (SG)is a commonly performed bariatric procedure. Weight re-gain following SG is a significant issue. The understanding of this phenomenon is still unclear. Rates of regain ranged from 5.7% at 2 years to 75.6% at 6 years. SASI bypass and OAGB were an option for some candidates having SG done 2 years back and failed to achieve the required weight loss or having weight regain. In SASI bypass, Re-sleeve gastrectomy of the dilated gastric pouch is done followed by plication of the stapler line then creating a Bipartition channel doing a side-to-side gastro-ileal anastomosis at 3 m of ileocaecal valve. In OAGB, transaction of stomach at claw foot level followed by resection of a dilated pouch is done, then a gastro-jejunostomy is created (end to side) at 200 cm from Duodena-Jejunal junction. The study aims to compare the effectiveness and safety of these procedures in terms of weight loss, improvement of comorbidities, and potential complications. Methods From February 2018 to February 2022, 180 patients had been divided in two groups depending on the procedures that had been performed in Sidra Kuwait Hospital and Hadi Hospital, Kuwait. A retrospective study comparing minigastric bypass (MGB/OAGB) and SASI bipartion as Revisional procedure after sleeve gastrectomy for non-responders (Inadequate weight loss) Exclusion criteria: Patients with history of Bypass Bariatric Surgery and patients with documented psychological instability or intolerability for regular follow up. Patients asking for primary bariatric procedure. Patients with non-dilated gastric pouch were excluded from the study (Evaluation had been done by Endoscopy and CT volumetry stomach study). Results 90 cases had been selected in each group .in SASI bipartition the gastro-ileal anastomosis was done 3 metres from ileocaecal valve and in MGB/OAGB: the gastro-jejunal anastomosis was done 2 metres from the Ligament of Treitz in both cases the gastro-intestinal anastomosis was 4 cm. Both groups had been followed up for the above-mentioned parameters (Weight loss, glycated haemoglobin, lipid profile, Serum albumin, serum iron and vitamins levels). Conclusion The study revealed that the weight loss was nearly the same in both groups Gastro-Oesophageal reflux was nearly same in both groups.