Trends in BMI, Glycemic Control and Obesity-Associated Comorbidities After Explantation of the Duodenal-Jejunal Bypass Liner (DJBL)

Riedel, Nina; Laubner, Katharina; Lautenbach, Anne; Schön, Gerhard; Schlensak, Matthias; Stengel, R; Eberl, Thomas; Dederichs, Frank; Aberle, Jens; Seufert, Jochen

doi:10.1007/s11695-018-3144-9

Cited by 8 publications

(4 citation statements)

References 27 publications

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“…Unlike RYGB, the Endobarrier is a temporary measure and implantation is currently limited to 12 months. Literature on the Endobarrier to date suggests that there is weight regain following explantation of the device but several studies have reported sustained weight loss up to one year after explant [57,58]. It can be postulated, given the general increase in absolute PUFA concentrations observed in this study beyond the end of the initial calorie restriction, that the reductions in PUFA concentrations are unlikely to be maintained following explantation, but this is unknown.…”

Section: Discussionmentioning

confidence: 72%

The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

et al. 2021

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Background & aims: Duodenal-jejunal bypass liners (DJBLs) prevent absorption in the proximal small intestine, the site of fatty acid absorption. We sought to investigate the effects of a DJBL on blood concentrations of essential fatty acids (EFAs) and bioactive polyunsaturated fatty acids (PUFAs). Methods: Sub-study of a multicentre, randomised, controlled trial with two treatment groups. Patients aged 18e65 years with type-2 diabetes mellitus and body mass index 30e50 kg/m 2 were randomised to receive a DJBL for 12 months or best medical therapy, diet and exercise. Whole plasma PUFA concentrations were determined at baseline, 10 days, 6 and 11.5 months; data were available for n ¼ 70 patients per group. Results: Weight loss was significantly greater in the DJBL group compared to controls after 11.5 months: total body weight loss 11.3 ± 5.3% versus 6.0 ± 5.7% (mean difference [95% CI] ¼ 5.27% [3.75, 6.80], p < 0.001). Absolute concentrations of both EFAs, linoleic acid and a-linolenic acid, and their bioactive derivatives, arachidonic acid, eicosapentaenoic acid, docosapentaenoic acid and docosahexaenoic acid, were significantly lower in the DJBL group than in the control group at 6 and 11.5 months follow-up. Total serum cholesterol, LDL-cholesterol and HDL-cholesterol were also significantly lower in the DJBL group. Conclusion: One year of DJBL therapy is associated with superior weight loss and greater reductions in total serum cholesterol and LDL-cholesterol, but also depletion of EFAs and their longer chain derivatives. DJBL therapy may need to be offset by maintaining an adequate dietary intake of PUFAs or by supplementation. Trial registration: ClinicalTrials.gov Identifier NCT02459561.

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Section: Discussionmentioning

confidence: 72%

The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

et al. 2021

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“…At explantation, TBWL was 12.6 ± 1.3 kg (p < 0.0001), which was maintained at 6-month follow-up, significantly lower (− 7.07 kg, p < 0.0001) than at baseline, HbA 1C decreased 1.3% (95% CI, 1.0, 1.6; p < 0.0001), and FPG decreased 44.6 mg/dL (31.2, 57.9; p < 0.0001) [202]. After EndoBarrier explantation, HbA 1C and BMI often increase but remain significantly below baseline levels [203]. The device is associated with mean T2DM resolution of 47.0% at 1-year follow-up [199].…”

Section: Indications/contraindications Weight Loss Diabetes Resolutionmentioning

confidence: 93%

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Bhandari

Fobi

Buchwald³

2019

OBES SURG

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Background Standardization of the key measurements of a procedure's finished anatomic configuration strengthens surgical practice, research, and patient outcomes. A consensus meeting was organized to define standard versions of 25 bariatric metabolic procedures. Methods A panel of experts in bariatric metabolic surgery from multiple continents was invited to present technique descriptions and outcomes for 4 classic, or conventional, and 21 variant and emerging procedures. Expert panel and audience discussion was followed by electronic voting on proposed standard dimensions and volumes for each procedure's key anatomic alterations. Consensus was defined as ≥ 70% agreement. Results The Bariatric Metabolic Surgery Standardization World Consensus Meeting (BMSS-WOCOM) was convened March 22-24, 2018, in New Delhi, India. Discussion confirmed heterogeneity in procedure measurements in the literature. A set of anatomic measurements to serve as the standard version of each procedure was proposed. After two voting rounds, 22/25 (88.0%) configurations posed for consideration as procedure standards achieved voting consensus by the expert panel, 1 did not attain consensus, and 2 were not voted on. All configurations were voted on by ≥ 50% of 50 expert panelists. The Consensus Statement was developed from scientific evidence collated from presenters' slides and a separate literature review, meeting video, and transcripts. Review and input was provided by consensus panel members. Conclusions Standard versions of the finished anatomic configurations of 22 surgical procedures were established by expert consensus. The BMSS process was undertaken as a first step in developing evidence-based standard bariatric metabolic surgical procedures with the aim of improving consistency in surgery, data collection, comparison of procedures, and outcome reporting.

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“…Looking at alternative therapies, other endoscopic procedures are evolving that appear to be more effective in the metabolic respect: the duodenal-jejunal bypass sleeve mimics the situation after Y-roux bypass surgery by bypassing the duodenal mucosa. Despite beneficial effects on glycemic control and body weight (64,65), the CE Certificate of conformity was withdrawn in 2017 due to a deficient quality management system. The results of a new pivotal trial will decide on a comeback of the device (47).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic intragastric balloon: a gimmick or a viable option for obesity?

Gollisch¹,

Roggenbuck²

2020

Ann Transl Med

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Worldwide, the prevalence of obesity has doubled since 1980 in 70 countries. More than one in three adults now suffer from overweight or obesity. Health problems related to obesity include orthopedic problems, psychiatric conditions, metabolic and cardiovascular diseases, and of increasing concern, cancer.Thus, obesity has an enormous impact on the individual's wellbeing as well as on society's workforce and health care expenses. Medical efforts are ongoing to find safe and effective treatment options for obesity and its metabolic implications. At present, available treatment options include lifestyle interventions, pharmacotherapy, endoscopic applications, and bariatric surgery. Within the range of endoscopic treatment options, the intragastric balloon is the most widely used device. The idea is simple: the gastric volume is reduced by a balloon that is in most cases implanted by an endoscopic procedure similar to a gastroscopy.During the past decades, different models have been developed, which we will briefly introduce in this review. We aim at reviewing the pathophysiology underlying the effect of endoscopic intragastric balloon on weight loss and metabolic changes. We will assess expected short-term and long-term benefits for the patient, and we will discuss common side effects as well as rare complications. We will compare endoscopic intragastric balloon to conservative treatment options with or without pharmacological support on the one hand and to the spectrum of bariatric surgery on the other hand. In most patients, obesity must be considered a chronic disease that requires a lifelong treatment concept. In view of current treatment options for obesity, we will discuss whether endoscopic intragastric balloon is a viable treatment option, and who may be the right patient to benefit from it.

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Trends in BMI, Glycemic Control and Obesity-Associated Comorbidities After Explantation of the Duodenal-Jejunal Bypass Liner (DJBL)

Abstract: ClinicalTrials.gov Identifier: NCT02731859.

Cited by 8 publications

References 27 publications

The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Endoscopic intragastric balloon: a gimmick or a viable option for obesity?

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