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Sleeve gastrectomy (SG) is currently regarded as a standalone procedure for most morbidly obese patients due to its results for both weight loss and comorbidity resolution. Nevertheless, up to 64 and 70% of patients can present with insufficient weight loss and weight regain in the long term. Hence revisional techniques are often needed in order to improve both weight loss and metabolic control. Although there is no consensus on which technique should be performed after SG as a second-step procedure, Roux-en-Y Gastric Bypass (RYGBP), re-sleeve and bilio-pancreatic diversions (duodenal switch, SADI-S, SIPS) are commonly considered. Due to its excellent results for both weight loss and comorbidity improvement, specially in super-obese patients, duodenal switch can be an optimal option for those patients with very significant weight regain or por metabolic control.
