Perioperative Outcomes Following Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S): Analysis of a National Multicenter Mexican Cohort.

BACKGROUND

Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) is widely recognized as an effective metabolic bariatric procedure. However, limited data are available regarding its perioperative safety in Latin American populations.

OBJECTIVES

To evaluate the perioperative safety of SADI-S, describe the type and frequency of complications, and identify clinical factors associated with adverse outcomes across multiple centers in Mexico.

METHODS

A retrospective multicenter cohort study was conducted including adults who underwent primary or revisional SADI-S between January 2019 and April 2025 in 15 accredited bariatric centers in Mexico. Demographic, clinical, and perioperative variables were analyzed. Associated factors for complications were assessed using multivariable binary logistic regression analyses.

RESULTS

A total of 520 patients were included, 76.2% women, with a median age of 46 years and a median BMI of 59 kg/m². Revisional procedures accounted for 27.7%. Postoperative complications occurred in 2.5% of patients, including bleeding (1%), leaks (0.6%), and abscesses (0.4%), with no mortality. Operative time and estimated blood loss were independently associated with complications. Outcomes were comparable between primary and revisional SADI-S cases within this cohort.

CONCLUSIONS

SADI-S can be performed with acceptable perioperative morbidity by experienced bariatric surgeons, even in high-BMI and revisional cases. Longer operative time and increased estimated blood loss were associated with a higher risk of perioperative complications.