The EndoBarrier: Duodenal-Jejunal Bypass Liner for Diabetes and Weight Loss

Ruban, Aruchuna; Ashrafian, Hutan; Teare, Julian

doi:10.1155/2018/7823182

Cited by 56 publications

(42 citation statements)

References 36 publications

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“…An increase in BA was also seen in patients receiving DJBS, although no changes in anatomy and intestinal transit time are present after the procedure [106]. Other, not yet elucidated mechanisms, must play a role in the alteration of BA in these patients.…”

Section: Bile Acids After Endoscopic Bariatric Proceduresmentioning

confidence: 83%

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

Olst

Meiring

Brauw

et al. 2020

Techniques and Innovations in Gastrointestinal Endoscopy

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Incretins, bile acids and the gut microbiome are involved in the pathophysiology of obesity and type 2 diabetes. The incretins glucagon-like peptide-1 and glucose-dependent-insulinetrophic polypeptide, both influence beta-cell function, insulin and glucose sensitivity, and food intake. Studies have shown that concentrations of both incretins change after bariatric surgery and nowadays glucagon-like peptide-1 agonists are administered as glucose and body weight regulating agents. Bile acids also play an important role in glycemic and metabolic regulation via multiple signaling pathways. After bariatric surgical interventions increase in bile acid concentrations have been observed combined with improvement of metabolic health. It is not clear though, whether this is a direct effect of the altered concentration of bile acids or an epiphenomenon. In addition, alterations in the microbiome are seen in patients with type 2 diabetes and people with obesity. The gut microbiome, probably together with incretins and bile acids, is essential in digestion and nutrient metabolism. After bariatric procedures several alterations in bacterial abundance have been demonstrated with specific bacterial species having different effects on glycemic and metabolic conditions

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Section: Bile Acids After Endoscopic Bariatric Proceduresmentioning

confidence: 83%

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

Olst

Meiring

Brauw

et al. 2020

Techniques and Innovations in Gastrointestinal Endoscopy

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“…One pig developed an intestinal obstruction because of a DJBL prolapse that spontaneously resolved. Worldwide registry data of 492 patients with DJBL found that the rate of device migration was 3% with an intestinal obstruction of 0.3% of cases ( 20 , 21 ). Central line infection in one pig in our study was not related to either study device.…”

Section: Discussionmentioning

confidence: 99%

A Preclinical Animal Study of Combined Intragastric Balloon and Duodenal-Jejunal Bypass Liner for Obesity and Metabolic Disease

Ghoz

Jaruvongvanich

Matar

et al. 2020

Clin Transl Gastroenterol

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INTRODUCTION: Endoscopic bariatric and metabolic therapies can potentially reproduce similar gastric and small intestinal anatomic and physiologic manipulations as Roux-en-Y gastric bypass. This proof of concept animal study was aimed to assess the feasibility, safety, efficacy, and impact on gastrointestinal physiology of combined intragastric balloons (IGB) and duodenal-jejunal bypass liner (DJBL) for the treatment of obesity. METHODS: Five Ossabaw pigs were fed a high-calorie diet to develop obesity and were randomly assigned to receive IGB or DJBL in sequence. The weight gain rate was calculated. Fasting and postprandial blood samples were drawn before any intervention (serving as the baseline group) and 1 month after second device insertion (serving as the combination group) to measure gut neurohormonal changes and metabolic parameters. RESULTS: Four pigs successfully received a sequential device insertion. One pig developed duodenal sleeve prolapse that was spontaneously resolved. One pig was early terminated because of developing a central line infection. The rate of weight gain in the combination group (0.63 ± 1.3 kg/wk) was significantly lower than the baseline group (1.96 ± 2.17 kg/wk) and numerically lower than after insertion of the IGB (1.00 ± 1.40 kg/wk) or the DJBL (0.75 ± 2.27 kg/wk) alone. A trend of higher postprandial glucagon-like peptide-1 was observed in the combination group compared with the baseline group. DISCUSSION: A combination of IGB and DJBL is feasible and well tolerated. A strategy of sequential use of these devices might offer a synergistic approach that can enhance weight loss and metabolic outcomes.

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“…Endobarrier ® is a 60‐cm fluoropolymer liner that is anchored at the duodenal bulb and covers the enteric mucosal surface till the proximal jejunum and thus it is considered a duodenal‐jejunal bypass liner (DJBL) 38 . For this reason, it does not allow nutrients contact to the mucosa, while pancreatic juice and bile flow down between the liner and the mucosal surface.…”

Section: Duodenal Devicesmentioning

confidence: 99%

Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

Salomone¹,

Sharaiha

Boškoski

2020

Liver International

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Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in industrialized countries because of the worldwide epidemic of obesity. Beyond metabolic complications, a subset of patients with NAFLD develop non-alcoholic steatohepatitis (NASH) with fibrosis, which is emerging as a leading cause of liver transplantation due to progression to cirrhosis and cancer. For these reasons, NAFLD is considered a public health burden. In recent years endoscopic bariatric and metabolic therapies (EBMT) have emerged as safe and effective for the treatment of obesity and type 2 diabetes mellitus. EBMT include gastric and duodenal devices and techniques such as intragastric balloons, endoscopic sleeve gastroplasty, endoscopic small bowel by-pass and duodenal mucosal resurfacing. Observational studies and pilot trials have revealed beneficial effects of EBMT on NAFLD as assessed by noninvasive parameters or histology. In this review we summarise current evidence for the efficacy and safety of EBMT in obese patients with NAFLD and examine future clinical applications. K E Y W O R D S bariatric endoscopy, duodenal mucosal resurfacing, endoscopic sleeve gastroplasty, intragastric balloon, NAFLD, obesity How to cite this article: Salomone F, Sharaiha RZ, Boškoski I. Endoscopic bariatric and metabolic therapies for nonalcoholic fatty liver disease: Evidence and perspectives. Liver

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The EndoBarrier: Duodenal-Jejunal Bypass Liner for Diabetes and Weight Loss

Cited by 56 publications

References 36 publications

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

A Preclinical Animal Study of Combined Intragastric Balloon and Duodenal-Jejunal Bypass Liner for Obesity and Metabolic Disease

Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

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