ArticleObesity surgery2026
SADI-S as a Conversion for Suboptimal Clinical Response and Recurrent Weight Gain Following Bariatric Surgery: A Retrospective Cohort Study.
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecurrent weight gain (RWG) and Suboptimal Clinical Response (SCR) after primary metabolic and bariatric surgery (MBS) are common, often necessitating revisional procedures. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a promising conversion option.
methodsWe retrospectively reviewed patients who underwent laparoscopic conversion to SADI-S for RWG/SCR between 2018 and 2024. Eligible patients had prior MBS after meeting national guidelines. Data included demographics, weight-loss outcomes, complications and nutritional/metabolic markers. The primary outcomes were percent of total weight loss (%TWL) and excess weight loss (%EWL). Long-term complications and need for revisional surgery were also assessed.
resultsSixty-nine patients (mean age 42.7 ± 9.8 years; 66.7% female) were included. Most (65.2%) were converted from sleeve gastrectomy. Mean follow-up was 2.2 ± 1.4 years. Mean %TWL was 36.4%, 37.8%, and 34.5% at 1, 3, and 5 years, respectively, and %EWL exceeded 90% at all time points. Major complications (Clavien-Dindo ≥ 3b) occurred in 5.8% within 90 days, with 4 reoperations in the perioperative period. No conversional surgeries were required during the follow-up period.
conclusionsConversion to SADI-S is a safe and effective option for RWG/SCR following primary MBS, yielding durable weight loss and metabolic improvement with low complication rates. These findings support its use as a conversion strategy, warranting further prospective validation.
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