Literature DB >> 22534421

Weight loss and metabolic improvement in morbidly obese subjects implanted for 1 year with an endoscopic duodenal-jejunal bypass liner.

Alex Escalona1, Fernando Pimentel, Allan Sharp, Pablo Becerra, Milenko Slako, Dannae Turiel, Rodrigo Muñoz, Claudia Bambs, Sergio Guzmán, Luis Ibáñez, Keith Gersin.   

Abstract

OBJECTIVE: To evaluate safety, weight loss, and cardiometabolic changes in obese subjects implanted with the duodenal-jejunal bypass liner (DJBL) for 1 year.
BACKGROUND: The DJBL is an endoscopic implant that mimics the duodenal-jejunal bypass component of the Roux-en-Y gastric bypass. Previous reports have shown significant weight loss and improvement in type 2 diabetes for up to 6 months.
METHODS: Morbidly obese subjects were enrolled in a single arm, open label, prospective trial and implanted with the DJBL. Primary endpoints included safety and weight change from baseline to week 52. Secondary endpoints included changes in waist circumference, blood pressure, lipids, glycemic control, and metabolic syndrome.
RESULTS: The DJBL was implanted endoscopically in 39 of 42 subjects (age: 36 ± 10 years; 80% female; weight: 109 ± 18 kg; BMI: 43.7 ± 5.9 kg/m); 24 completed 52 weeks of follow-up. Three subjects could not be implanted due to short duodenal bulb. Implantation time was 24 ± 2 minutes. There were no procedure-related complications and there were 15 early endoscopic removals. In the 52-week completer population, total body weight change from baseline was -22.1 ± 2.1 kg (P < 0.0001) corresponding to 19.9 ± 1.8% of total body weight and 47.0 ± 4.4% excess of weight loss. There were also significant improvements in waist circumference, blood pressure, total and low-density lipoprotein cholesterol, triglycerides, and fasting glucose.
CONCLUSIONS: The DJBL is safe when implanted for 1 year, and results in significant weight loss and improvements in cardiometabolic risk factors. These results suggest that this device may be suitable for the treatment of morbid obesity and its related comorbidities. This study was registered at www.clinicaltrials.gov (NCT00985491).

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Year:  2012        PMID: 22534421     DOI: 10.1097/SLA.0b013e31825498c4

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  40 in total

1.  Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement.

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

Authors:  Radwan Kassir; Jean Gugenheim; Imed Ben Amor; Rani Kassir; Frédérique Sauvat
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3.  Safety and efficacy of the endoscopic duodenal-jejunal bypass liner prototype in severe or morbidly obese subjects implanted for up to 3 years.

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Review 7.  The duodenal-jejunal bypass liner for the treatment of type 2 diabetes mellitus and/or obesity: a systematic review.

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Journal:  Obes Surg       Date:  2014-02       Impact factor: 4.129

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9.  Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery.

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10.  Baseline glycated hemoglobin levels are associated with duodenal-jejunal bypass liner-induced weight loss in obese patients.

Authors:  Rodrigo Muñoz; Angelica Dominguez; Fernando Muñoz; Cesar Muñoz; Milenko Slako; Dannae Turiel; Fernando Pimentel; Alan Sharp; Alex Escalona
Journal:  Surg Endosc       Date:  2013-11-07       Impact factor: 4.584

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