SADI-S with Extended Duodeno-Bulb Preservation: Case Report

Obesity has been growing in Brazil and the world. It is reaching epidemic proportions, bariatric surgery most effective treatment for patients with this disease. Among procedures described literature, ileal surgeries such as biliopancreatic diversion duodenal switch (BPD-DS) single-anastomosis duodeno-ileal bypass sleeve gastrectomy (SADI-S) present better long-term results terms of weight loss comorbidities control. However, there are concerns regarding long term nutritional problems these procedures. In case report aim to demonstrate technical feasibility preserving an extended bulb segment, SADIS-S procedure, when difficulties dissecting retrobulbar region, occurred here, due fibrosis area. This assures maintenance proposed surgical technique, a situation. The dissection transection duodenum was done 7 cm distally pylorus, under endoscopic view, proximally papillae, where tissue normal. Additionally, importance mucosa on minerals trace elements absorption release important hormones elicits evaluation impact modification, which casually, nutritional, hormonal metabolic results, term. report, length demonstrated reasonable loss, adequate control good status, so far. These aspects must be evaluated term, by clinical trials.