Long-term effects of proximal small bowel exclusion by duodenal-jejunal bypass liner on weight reduction and glycemic control in diabetic patients

Abstract Background Exclusion of the proximal gut from nutrient absorption entails significant metabolic benefits. The duodenal-jejunal bypass liner (DJBL) is the first endoscopic device that excludes the first part of the gut by covering it. Objectives To assess weight and glycemic control at the end of treatment and after 1 year of follow-up. Setting Bariatric endoscopy service in a tertiary medical center. Methods Diabetic patients were treated with DJBL and followed prospectively between 2013 and 2016. Data were collected during scheduled visits. Results Out of 51 patients treated, 39 completed at least 9 months with the device. Complications were recorded for the entire cohort. Percent of total weight loss was 15.05% ± 6.0% after 12 months of treatment ( P P 2 experienced greater percent total weight loss changes over time ( P P  = .003), and the nadir was reached at 9 months of treatment (median 6.05% versus 7.20% at baseline, P P Conclusions Proximal bowel bypass by DJBL is an effective tool for weight reduction and glycemic control. Metabolic achievements are partially preserved at 1 year after device removal. Because DJBL entails a considerable rate of side effects, strategies to mitigate them are warranted.