Computed Tomography-Derived Gastric Sleeve Volumetry as an Adjunctive Tool for Planning Revisional Single Anastomosis Duodeno-ileal Bypass in Patients with Suboptimal Weight Loss After Sleeve Gastrectomy
In brief
Revisional SADI achieves roughly 40% total weight loss, adding 27% beyond the original sleeve
In 23 women with inadequate loss after sleeve gastrectomy, revisional single-anastomosis duodeno-ileal bypass produced an average 40% total weight loss, representing an extra 27% compared with the sleeve alone, over a median 21-month follow-up. Pre-operative CT volumetry guided concurrent sleeve reduction in most cases, with manageable complications, suggesting CT-based sizing (≈110 ml) may help tailor revisions.
- Journal
- Obesity surgery (Q1)
- Published
- 31 August 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Ji Young Ye, Seong Min Kim
- PMID
- 42671499
- DOI
- 10.1007/s11695-026-08917-6
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 1 September 2026): CT sleeve volumetry guides revisional SADI
Abstract
INTRODUCTION: Single-anastomosis duodeno-ileal bypass (SADI) is an effective revision procedure for patients with suboptimal weight loss after sleeve gastrectomy (SG). However, the clinical value of concomitant revisional SG (ReSG) during revisional SADI remains unclear. This study evaluated the outcomes of revisional SADI with selective ReSG guided by preoperative computed tomography (CT) volumetry. METHODS: This single-center retrospective study analyzed prospectively collected data of patients who underwent revisional SADI following SG between 2019 and 2023. Preoperative CT volumetry was used to measure gastric tube, antral, and total sleeve volumes. ReSG was selectively performed based on CT-derived volumetric findings and intraoperative assessments. Perioperative outcomes, complications, and weight-loss parameters were reviewed. RESULTS: Twenty-three female patients underwent revisional SADI and completed at least 12 months of follow-up. The mean interval between primary SG and revision was 41.3 ± 21.6 months. ReSG was performed in 20 patients, whereas three underwent SADI only. The mean follow-up duration after revision was 21.4 ± 9.0 months. The mean percent total weight loss (%TWL) after revisional SADI was 40.2 ± 5.4%, an additional 27.4 ± 8.8% compared with SG only. The postoperative complications were manageable, including one thromboembolic event and two malnutrition cases, one of which required reversal surgery. CONCLUSION: Revisional SADI was associated with substantial additional weight reduction in patients with suboptimal weight loss after SG. Concurrent ReSG may be considered in select patients with enlarged gastric sleeve segments. Preoperative CT sleeve volumetry may provide adjunctive surgical planning support, with approximately 110 ml serving as the exploratory reference point.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.