Comparative Outcomes of Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass in Adults with Severe Obesity: A Systematic Review and Meta-Analysis
In brief
SADI-S achieves modestly greater weight loss than Roux-en-Y gastric bypass
A meta-analysis of 12 studies (3,317 patients) found that single-anastomosis duodeno-ileal bypass with sleeve gastrectomy produced slightly more weight loss than Roux-en-Y, while rates of diabetes, hypertension, dyslipidemia remission and early complications were similar. The procedure may lower reoperation and some late complications, but evidence is low-certainty and long-term mortality data are lacking.
- Journal
- Obesity surgery (Q1)
- Published
- 15 September 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Ali Altwaheih, Feras W Atieh, Ibrahim Abdel-Jaleel, Omar Abdelghani, Mohammad G Alomari, Sondos Jallad, et al.
- PMID
- 42742831
- DOI
- 10.1007/s11695-026-08934-5
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 17 September 2026): Systematic review compares SADI‑S vs RYGB effectiveness
Abstract
Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is increasingly used for severe obesity, but its comparative effectiveness versus Roux-en-Y gastric bypass (RYGB) remains uncertain. This systematic review and meta-analysis included 12 comparative studies (3,317 patients) identified through searches of major databases to April 2026. Random-effects meta-analyses suggested a potential weight-loss benefit with SADI-S compared with RYGB at selected follow-up points, while no clear differences were observed in remission of type 2 diabetes, hypertension, or dyslipidemia, or in HbA1c reduction. No clear differences were observed in operative outcomes or early complications, while the findings suggested potential reductions in reoperations and selected late surgical complications with SADI-S; a nonsignificant trend toward greater calcium deficiency was also observed. Evidence certainty was predominantly low or very low because of methodological limitations and heterogeneity. Comparative mortality could not be assessed because no included study provided mortality data suitable for pooling, highlighting the need for high-quality long-term randomized studies.
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.