Prospective Randomized Study Comparing the Outcomes of Single Anastomosis Sleeve Jejunal Bypass (SAS-J) with One Anastomosis Gastric Bypass (OAGB)

Abstract Background One Anastomosis Gastric Bypass is one of the commonest bariatric surgeries worldwide, which has been demonstrated to produce excellent bariatric and metabolic outcomes. Single Anastomosis Sleeve Jejunal Bypass is a novel procedure that was developed in Hazrat e Rasool Hospital by Pazouki and Kermansavari in 2019 to form an anastomosis between the sleeved stomach and the jejunum rather than the ileum as a modification of the previously known SASI. Objective To compare the outcome of SASJ with OAGB as regards efficacy and safety in a 6- month postoperative follow up period. Patients and Methods This was a comparative prospective randomized study conducted in Ain Shams University Hospitals, over 40 patients devided into 2 groups. First group was composed of 20 patients who underwent SASJ operation, and second group was composed of 20 patients who underwent OAGB operation. Results The mean excess weight loss percentage after 6 months of SASJ group of patients was 51.55% ± 15.11, and 58.30% ± 24.32 in OAGB group. Both groups showed excellent outcomes as regards comorbidities resolution. In OAGB group, there was 1 patient who had postoperative bleeding. In SASJ group, we had one case of reflux alkaline gastritis that needed readmission. In addition, we had one case (5%) that needed reoperation and conversion to Roux-en Y configuration. In SASJ group, there were 7 patients complained from bile reflux, and 3 patients in OAGB group. In SASJ group of patients we had only 1 patient who developed postoperative gall bladder stones, and 6 patients in OAGB group. Conclusion Both OAGB and SASJ are effective bariatric procedures as regards weight loss and comorbidities resolution such as DM, HTN and hyperlipidemia. Incidence of biliary reflux was found more among the SASJ patients, but it was almost overcomed after performing the antireflux suture.