An Analysis of Mid-Term Complications, Weight Loss, and Type 2 Diabetes Resolution of Stomach Intestinal Pylorus-Sparing Surgery (SIPS) Versus Roux-En-Y Gastric Bypass (RYGB) with Three-Year Follow-Up.

Background: For many years, the Roux-en-Y Gastric Bypass (RYGB) was considered a good balance of complications and weight loss. According to several short-term studies, single anastomosis duodenal switch or stomach intestinal pylorus sparing surgery (SIPS) offers similar weight loss to RYGB with fewer complications and better diabetes resolution. No one has substantiated mid-term complication and nutritional differences between these two procedures. This paper seeks to compare complication and nutritional outcomes between RYGB and SIPS.

Methods: A retrospective analysis of 798 patients who either had SIPS or RYGB from 2010 to 2016. Complications were gathered for each patient. Nutritional outcomes were measured for each group at 1, 2, and 3 years. Regression analysis was applied to interpolate each patient's weight at 3, 6, 9, 12, 18, 24, and 36 months. These were then compared with t tests, Fisher's exact tests, and chi-squared tests.

Results: RYGB and SIPS have statistically similar weight loss at 3, 6, 9, 12, and 36 months. They statistically differ at 18 and 24 months. At 36 months, there is a trend for weight loss difference. There were only statistical differences in nutritional outcomes between the two procedures with calcium at 1 and 3 years and vitamin D at 1 year. There were statistically significantly more long-term class IIIb-V complications, class I-IIIa complications, reoperations, ulcers, small bowel obstructions, nausea, and vomiting with the RYGB than the SIPS.

Conclusion: With comparable weight loss and nutritional outcomes, SIPS has fewer short- and long-term complications than RYGB and better type 2 diabetes resolution rates.