Revisional single anastomosis duodeno-ileal bypass with sleeve gastrectomy after failed adjustable gastric band or sleeve gastrectomy: a meta-analysis of efficacy and safety

Dec 10, 2025Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Effectiveness and safety of revising weight loss surgery by connecting the stomach to the lower intestine after failed gastric band or sleeve gastrectomy

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Abstract

Eighteen articles with 1641 revisional cases indicate that single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a safe and effective option for patients with failed primary procedures.

  • BMI change after SADI-S was 11.01 kg/m² at 12 months, 9.57 kg/m² at 36 months, and 11.04 kg/m² at 60 months.
  • Total weight loss after SADI-S was 23.78% at 12 months, 21.03% at 36 months, and 22.11% at 60 months.
  • SADI-S was associated with remission rates of 69% for diabetes, 41% for hypertension, 47% for hyperlipidemia, and 69% for obstructive sleep apnea.
  • Reported complications included leaks (2.9%), gastroesophageal reflux disease (5.1%), anemia (5.7%), diarrhea (8.7%), nutritional deficiency (4.2%), and steatorrhea (11.2%).
  • In subgroup analysis, SADI-S, one anastomosis gastric bypass, and Roux-en-Y gastric bypass showed comparable outcomes in weight loss and resolution of obesity-related comorbidities.

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