Document Type

Article

Publication Title

Annals of Laparoscopic and Endoscopic Surgery

Abstract

Background and Objective: Metabolic and bariatric surgery (MBS) is an excellent therapeutic modality for sustained weight loss management and obesity-related medical conditions resolution. In the current bariatric era, there exists multiple procedures and approaches. Despite sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) being the most commonly performed procedures, the duodenal switch (DS) is a more recent procedure that has shown promising outcomes. DS procedures include the classic biliopancreatic diversion with DS (BPD-DS) and the single anastomosis duodeno-ileostomy with sleeve (SADI-S). DS surgical techniques have been amended multiple times over the last decade in order to obtain optimal patient outcomes. However, bariatric surgeons are still reluctant to offer the DS as a stand-alone procedure primarily due to the perceived long-term complication rates. Therefore, we performed a review article of the available literature to highlight the role and significance of the DS in MBS, emphasizing its multifaceted benefits and the need for continued research to maximize patient outcomes and understand its full potential in the bariatric surgery landscape.

Methods: An extensive literature review (LR) was conducted to define research questions and relevant keywords. Selected databases such as PubMed, ScienceDirect, and Springer Link were searched from inception until 2023 to identify several keywords and locate relevant articles written in English.

Key Content and Findings: Our narrative review demonstrated that DS procedures are associated with favorable weight loss outcomes while also having low morbidity and mortality rates. Additionally, there is an increasing adoption rate within the bariatric field due to the role of technological advancements in overcoming previous technical challenges.

Conclusions: The increased implementation of BPD-DS and SADI-S in the current bariatric era is supported by the favorable safety and efficacy profile compared to other traditional MBS procedures. Further long-term comparative studies are needed to support these findings and reinforce the DS’s role amongst bariatric surgeons.

DOI

10.21037/ales-24-9

Publication Date

10-30-2024

Keywords

Metabolic and bariatric surgery (MBS), duodenal switch (DS), long-term outcomes, biliopancreatic diversion with duodenal switch (BPD-DS), single anastomosis duodeno-ileostomy with sleeve (SADI-S)

ISSN

2518-6973

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