There are no comparative studies on the long-term outcomes after the traditional duodenal switch (DS) and single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S).Aim Compare the long-term outcomes (> five years).Setting Single private institute, USA.


Data from 815 patients who underwent primary traditional DS or SADI-S were used for a retrospective matched cohort. Data were obtained by matching every DS patient to a SADI-S patient of the same age, sex, and BMI. Besides, only patients that were out five years, and had at least one >five-year follow-up were included.


The matched cohort included 30 DS and 30 SADI-S patients. At five years, a 100% follow-up was available in each group. The SADI-S patients had significantly lower blood loss, shorter length of stay and operative time. The short-term complication rates were statistically similar; however, the long-term complication rates were significantly fewer with SADI-S. The long-term Clavien-Dindo grade IIIb complications were significantly fewer with SADI-S. Weight loss was significantly better with the DS at six years. However, there was no statistically significant difference in the ending BMIs. The median highest %EWL trend, nadir BMI trend, and the last available follow-up %EWL trend with both procedures were similar. The long-term resolution rates of OSA, T2D, GERD, and HTN, and nutritional outcomes were statistically similar. The long-term failure rates were comparable.


The SADI-S procedure offers comparable comorbidity resolution rates and nutritional outcomes; however, the DS seems to offer somewhat better weight loss at the cost of patient complications.