Sleeve gastrectomy plus single anastomosis sleeve ileal bipartition versus sleeve gastrectomy alone: The role of bipartition

Asian J Endosc Surg. 2025 Jan-Dec;18(1):e13398. doi: 10.1111/ases.13398.

Abstract

Background: Sleeve gastrectomy (SG) with single anastomosis sleeve ileal bipartition (SASI) is a novel procedure for increasing the anti-metabolic efficacy of SG in severely people with obesity.

Objectives: This study aimed to compare 1-year results between SASI and SG, thereby assessing the role of bipartition.

Setting: The study was conducted at the Medical University hospital.

Methods: Between November 2021 and December 2022, 39 patients received an SG + SASI surgery, a total of 35 patients completed 1-year follow-up after the surgery. They were matched with a group of 70 patients with SG that were equal in age, sex, and body mass index (BMI). Operative risk, weight loss, and remission of comorbidities were evaluated after 12 months.

Results: The operation time of the SASI group was significantly longer than the SG group (140.3 ± 22.8 vs. 114.9 ± 21.6 min; p < .001). At 12 months after surgery, the SASI group had better weight loss (total weight loss: 37.0% vs. 29.7%; p = .001) and achieved a lower BMI than SG (23.4 ± 2.6 kg/m2 vs. 24.6 ± 2.9 kg/m2; p = .046). Reduction of A1C and remission of T2D was greater in the SASI group. The SASI group had a higher reduction in uric acid, low-density lipoprotein, total cholesterol, and triglyceride levels after operation than the SG group. However, the SG group is superior to the SASI group in mean corpuscular volume, calcium, and iron levels.

Conclusions: In this study, adding an ileum bipartition to SG increases the weight loss, glycemic, and blood lipid control of SG only.

Keywords: SASI; bipartition; complications.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anastomosis, Surgical / methods
  • Body Mass Index
  • Female
  • Gastrectomy* / methods
  • Humans
  • Ileum* / surgery
  • Male
  • Middle Aged
  • Obesity, Morbid* / surgery
  • Operative Time
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss*