Sustained weight loss after duodenal–jejunal bypass liner treatment in patients with body mass index below, but not above 35 kg/m²: A retrospective cohort study

Abstract

Previous data from short term studies have shown an efficacy of the duodenal-jejunal bypass liner (DJBL) for weight loss. However, less data is available regarding weight change after device removal and possible predictors for weight loss. This is a retrospective chart review of all patients who had DJBL inserted at the University Hospital Zurich between December 2012 and June 2015. A total of 27 patients had DJBL insertion. The median BMI at baseline was 38.5 (34.0-42.2) kg/m 2 . In the 24 patients with DJBL treatment >3 months (failed implantation or early removal due to side effects in 3 patients), the mean duration of implantation was 42.9 ± 13.1 weeks. During the treatment, the mean total body weight loss (%TBWL) was 15.0 ± 8.3%. Fifteen patients had long-term follow-up data available (mean duration of follow-up 4.0 ± 0.9 years). The mean weight change was 12.7 ± 12.8 kg, corresponding with a mean % weight regain of 13.3 ± 13.3%. Five patients (33.3%) subsequently underwent bariatric surgery. In patients with class I obesity (BMI <35 kg/m 2 at baseline), 4 out of 6 (66.7%) had a stable weight or only a weight regain <7%.In contrast, no patient with BMI >35 kg/m 2 at baseline was able to keep weight regain below 7%. DJBL is an effective treatment for obesity, but substantial weight regain occurs during long-term follow up after the device removal, in particular in patients with BMI > 35 kg/m 2 .

Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control

“…In contrast, no patients with a body mass index (BMI) >35 kg/m 2 (at baseline) were able to maintain or present a weight regain <7%. 21 A study evaluated the outcomes at 4 years after DJBL explantation and showed improvement in AWL, %TWL, and BMI. However, none of these parameters were significantly different compared to baseline.…”

Overview on the endoscopic treatment for obesity: A review

“…Similar to previous research, in a multicenter open-label RCT, 24% of DJBS patients lost 15% of their body weight at 12 mo, compared to 4% of controls (odds ratio = 8.3, 95%CI: 1.8-39; P = 0.007). The inclusion of the DJBS to intense medical care was linked to greater weight loss and improvements in QoL[ 137 ]. However, significant weight recovery happens during long-term follow-up after device removal, particularly in people with BMIs larger than 35 kg/m 2 [ 138 ].…”