SADI-S, state of the art. Indications and results in 2024: a systematic review of literature

Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) was proposed as a simplification of the biliopancreatic diversion (BPD) procedure with duodenal switch (DS) in order to reduce operative time and postoperative complications rate, however, keeping effectiveness in weight loss and in comorbidities’ resolution. We performed a systematic review of the literature with the aim of summarizing the current evidence of SADI-S clinical outcomes in order to assess its effectiveness and safety, and a total of 17 studies were included. Short- and mid-term follow-up results were reported, with a mean TWL loss ≥ 25% at 12 months and > 44% after 24 months, comparable to BPD-DS, also in reoperative surgery. Comorbidity remission rates for T2D, hypertension, dyslipidemia and OSAS were of 75.8%, 61.2%, 60.4%, 71.9%, respectively. Some nutritional deficiencies were reported (total proteins, albumin, folate, Vitamin B12 and Vitamin D), but the hypoabsorption rate decreased with the lengthening of the common limb to 250/300 cm. SADI-S can be defined as an efficient bariatric operation both as primary and reoperative procedure for recurrent weight gain, with good results in comorbidity resolution.