Gagner/Pomp study on fat absorption

Interesting. Are there any studies comparing fat malabsorption in the SADI and other versions of the DS with the traditional DS?
 
Interesting. Are there any studies comparing fat malabsorption in the SADI and other versions of the DS with the traditional DS?
I wish. There was an article that mentioned that fat malabsorption stops in a SADI-S after 2 years but the article is no longer around
 
Oh, the article is around, if you don’t mind going to a pirate site for scientific publications. Or if you saved it when it was available.

Bottom line: after 12 mo., SADI patients had no fat malabsorption.
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A113
PHYSIOPATHOLOGICAL DIFFERENCES AFTER DUODENAL SWITCH AND SINGLE ANASTOMOSIS DUODENO ILEAL BYPASS (SADI-S)

Amador Garcia Ruiz1; Alejandro Bravo Salva2;
Jordi Elvira López3; Jordi Pujol Gebelli2;

1Hospital Universitario De Bellvitge, L'Hospitalet de Llobregat Barcelona; 2Hospital Universitario De Bellvitge, Barcelona Spain; 3Hospital Universitario De Bellvitge, Lhospitalet de Llobregat Spain

Introduction: Single Anastomosis Duodeno Ileal Bypass (SADI-S) is a technical simplification of conventional Duodenal Switch (DS), but with similar results in terms of weight loss and comorbidities evolution. SADI-S. Both techniques are considered equivalent but they have significant anatomical and physiological differences.

Objectives: We evaluated biliary salts and fat malabsorption after DS and SADI-S as a part of a multicentic randomized trial to compare long term results of both procedures.

Methods: Patients from our Institution who took part of the multicentric trial comparing both techniques. Both procedures were done with 6 trocars, sleeve gastrectomy was made over a 36F bougie, first portion of the duodenum was completely dissected and sectione 2-3 cm away of the pylorus. DS was made with a 100cm common channel and a 200cm Roux limb. SADIS was constructed with a 300cm common channel. All patients were scheduled for a breath test to evaluate Fat Malabsortion and for a SeHCAT elimination test to check biliary salts malabsorption. Tests were performed 3, 6 and 12 months after surgery. Bowel transit and the presence of steatorrhea was also evaluated.

Results: 41 patients were evaluated. 23 DS adn 18 SADI-S. Both groups were homogeneous in terms of age, sex, BMI and comorbidities. Bowel movements were 1-3 per day in both groups on average. No cases of steatorrhea were found.

Breath test for fat malabsorption showed pathological results in 77.78% of patients of DS and 60% of SADI-S after 3 months. At 12 months, these pathological results were found in 85.7% of DS patients, but no SADI-S patients had fat malabsorption.

Biliary salts malabsortion was found in 10% of patients of DS after 3 months, and in 14.3% after 12 months. None SADI-S patient had SeHCAT pathological test at any point of follow-up.

Conclusions: These preliminary results show some physiopatolo- gical differences between both techniques. DS patients had more fat malabsorption and some biliary salts malabsorption too. These differences are bigger as time goes by. We have not enough patients yet to determine if those differences can translate also differences in weight loss and comorbidities evolution after surgery.
 
“No cases of steatorrhea were found.”

Really? Twenty-three DSers and NOT ONE needed Ozium or Poo-Pourri? Amazing.
 
Thanks for the information. I am always curious how it is ok to promote these procedures without detailing the distinct differences. In my opinion if you tell me it is as good as the DS why would I not get the DS if that is the standard?
If I was buying a car and the price was the same between a Lexus ES 350 and a Ford Focus and your pitch for the Focus is it’s just as good as the Lexus why would I buy the Ford? People are being told that it is the same as and that sounds fraudulent to me.
 
If I was buying a car and the price was the same between a Lexus ES 350 and a Ford Focus and your pitch for the Focus is it’s just as good as the Lexus why would I buy the Ford? People are being told that it is the same as and that sounds
Well, both cars have 4 wheels, a steering wheel and an engine so I guess they consider that same?
 
True but the Lexus retains its value better. similar to the long term benefits of the traditional DS.
 
Thanks for the information. I am always curious how it is ok to promote these procedures without detailing the distinct differences. In my opinion if you tell me it is as good as the DS why would I not get the DS if that is the standard?
If I was buying a car and the price was the same between a Lexus ES 350 and a Ford Focus and your pitch for the Focus is it’s just as good as the Lexus why would I buy the Ford? People are being told that it is the same as and that sounds fraudulent to me.
Sounds similar to when I saw my first surgeon. He didn't believe I needed the DS and said something like, "You only need a Ford so why get the Ferrari?" I thought about it for a few days and decided if I my insurance would pay for the Ferrari then why not get it? I did not go with that first surgeon.
 

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