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J W M Greve, N D Bouvy
The EndoBarrier (duodenal-jejunal bypass liner) became available in 2009 as an endoscopic treatment method for obesity and type 2 diabetes mellitus (T2D). The treatment results in significant weight loss and improvement of the obesity-related morbidities such as T2D, non-alcoholic steatohepatitis, hypertension and other cardiovascular diseases. However, unexpected complications such as liver abscesses can occur, in addition to expected adverse events such as bleeding, obstruction, and migration. The incidence of these complications is low however, and to date no treatment-related mortality has occurred with the use of EndoBarrier...
2018: Nederlands Tijdschrift Voor Geneeskunde
Nisha Patel, Aruchuna Mohanaruban, Hutan Ashrafian, Carel Le Roux, James Byrne, John Mason, James Hopkins, Jamie Kelly, Julian Teare
BACKGROUND AND AIMS: Obesity associated with diabetes mellitus is a significant worldwide problem associated with considerable health care costs. Whilst surgical intervention is effective, it is invasive, costly and associated with complications. This study aims to evaluate the safety and efficacy of the EndoBarrier®, a duodenal-jejunal sleeve bypass as an alternative treatment of diabetes mellitus in obese patients. MATERIALS AND METHODS: This was a multi-centre, non-randomised trial recruiting obese patients with type 2 diabetes from three sites in the UK...
February 15, 2018: Obesity Surgery
Nuria Vilarrasa, Alexandra Fabregat, Silvia Toro, Amador García Gordejuela, Anna Casajoana, Mónica Montserrat, Pilar Garrido, Rafael López-Urdiales, Núria Virgili, Alejandra Planas-Vilaseca, Andreu Simó-Servat, Jordi Pujol
Endobarrier® is a minimally invasive, reversible endoscopic treatment for obesity. It provokes malabsorption along 60 cm of the small intestine, which can contribute to the development of vitamin deficiencies and to changes in bone mineral density (BMD). To determine the prevalence of nutrient deficiencies, changes in body composition and BMD during the first year after Endobarrier® placement. Twenty-one patients with type 2 diabetes met inclusion criteria. Levels of vitamins, micro and macronutrients were assessed prior and at 1, 3 and 12 months post-operatively...
January 19, 2018: European Journal of Clinical Nutrition
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
Patrice M Forner, Timothy Ramacciotti, John E Farey, Reginald V Lord
BACKGROUND: The duodenal-jejunal bypass liner (DJBL) is an endoscopically placed device designed to achieve weight loss and improve glycemic control in obese patients. Previous studies report promising results but typically included small patient numbers and short follow-up. This study aims to determine the safety and effectiveness of the device. METHODS: Study design: A series of all patients treated by the DJBL at our institutions. OUTCOME MEASUREMENTS: Weight loss, biochemical measures, complications...
December 2017: Obesity Surgery
Sarka Stolbova, Marek Benes, Lenka Petruzelkova, Jan Lebl, Stanislava Kolouskova
Hypothalamic dysfunction leading to severe obesity is a serious long-term consequence of paediatric craniopharyngioma. It compromises quality of life, leads to long-term metabolic hazards, and may shorten life expectancy. Therefore, a proactive approach is required. Conventional treatment of hypothalamic obesity is difficult and hardly successful. Experience with bariatric surgery is limited, especially in younger patients. Two retrospective studies recently reported on classic bariatric surgery in a small series of individuals after craniopharyngioma...
June 2017: Pediatric Endocrinology Reviews: PER
Eduardo Espinet Coll, Javier Nebreda Durán, Gontrand López-Nava Breviere, Julio Ducóns García, Manuel Rodríguez-Téllez, Javier Crespo García, Carlos Marra-López Valenciano
INTRODUCTION: Bariatric endoscopy includes a series of specific techniques focused on the management of obese patients. As a quality criterion, safety as expressed by a minimal incidence of serious complications is required in addition to efficacy. METHODS: A descriptive, retrospective, multicenter review of the experience recorded at seven hospitals included in the Grupo Español de Endoscopia Bariátrica (GETTEMO) in order to document the incidence, cause, and resolution (including legal consequences) of serious complications reported for each bariatric technique, and according to endoscopist expertise...
May 2017: Revista Española de Enfermedades Digestivas
K S C Gollisch, A Lindhorst, D Raddatz
Many obese people with type 2 diabetes develop non-alcoholic fatty liver disease, which may progress to liver fibrosis. EndoBarrier gastrointestinal liner is an innovative interventional treatment option for type 2 diabetic patients, which could affect diabetes associated liver disease. The aim of this retrospective study was to analyze the effect of 1-year EndoBarrier therapy on liver fibrosis and steatosis. As an indicator of fibrosis, liver stiffness was assessed by liver elastography at baseline, 2 weeks after EndoBarrier implantation and then every 3 months until explantation...
February 2017: Experimental and Clinical Endocrinology & Diabetes
Ulrich Rohde
Bariatric surgery (e.g. Roux-en-Y gastric bypass (RYGB)) has proven the most effective way of achieving sustainable weight losses and remission of type 2 diabetes (T2D). Studies indicate that the effectiveness of RYGB is mediated by an altered gastrointestinal tract anatomy, which in particular favours release of the gut incretin hormone glucagon-like peptide-1 (GLP-1). The EndoBarrier gastrointestinal liner or duodenal-jejunal bypass sleeve (DJBS) is an endoscopic deployable minimally invasive and fully reversible technique designed to mimic the bypass component of the RYGB...
November 2016: Danish Medical Journal
Ulrich Rohde, Cecilie A Federspiel, Peter Vilmann, Ebbe Langholz, Steffen U Friis, Martin Krakauer, Jens F Rehfeld, Jens J Holst, Tina Vilsbøll, Filip K Knop
AIMS: The duodenal-jejunal bypass sleeve ((DJBS) or EndoBarrier Gastrointestinal Liner) induces weight loss in obese subjects and may improve glucose homeostasis in patients with type 2 diabetes (T2D). To explore the underlying mechanisms, we evaluated postprandial physiology including glucose metabolism, gut hormone secretion, gallbladder emptying, appetite and food intake in patients undergoing DJBS treatment. MATERIAL AND METHODS: A total of 10 normal glucose-tolerant (NGT) obese subjects and 9 age-, body weight- and body mass index-matched metformin-treated T2D patients underwent a liquid mixed meal test and a subsequent ad libitum meal test before implantation with DJBS and 1 week (1w) and 26 weeks (26w) after implantation...
February 2017: Diabetes, Obesity & Metabolism
Nuria Vilarrasa, Amador García Ruiz de Gordejuela, Anna Casajoana, Xevi Duran, Silvia Toro, Eduard Espinet, Manoel Galvao, Joan Vendrell, Rafael López-Urdiales, Manuel Pérez, Jordi Pujol
BACKGROUND: The purpose of this study was to evaluate the efficacy and safety of Endobarrier® in grade 1 obese T2DM patients with poor metabolic control and the role of gastro-intestinal hormone changes on the metabolic outcomes. METHODS: Twenty-one patients aged 54.1 ± 9.5 years, diabetes duration 14.8 ± 8.5 years, BMI 33.4 ± 1.9 kg/m(2), and HbA1c 9.1 ± 1.3 %, under insulin therapy, were implanted with Endobarrier®. Fasting concentrations of PYY, ghrelin and glucagon, and AUC for GLP-1 after a standard meal test were determined prior to and at months 1 and 12 after implantation...
March 2017: Obesity Surgery
J Feisthammel, M Blüher, J Mössner, A Hoffmeister
The prevalence of obesity in the population has been increasing for many years. Due to associated comorbidities the treatment of obesity is becoming more important. Conservative treatment alone is often unsuccessful, particularly in cases of severe obesity. In these cases, multimodal therapy in specialized treatment units is warranted. Between conservative treatment and bariatric surgery, interventional endoscopic treatment options also play an increasing role. Nowadays, implantation of gastric balloons and duodenojejunal bypass liners (EndoBarrier) are the most often used endoscopic options...
August 2016: Der Internist
Renato V Soares, Silvana Perretta, Dana Mihaela Ignat, Michel Vix, Lee L Swanstrom
No abstract text is available yet for this article.
December 2016: Gastrointestinal Endoscopy
U Rohde, N Hedbäck, L L Gluud, T Vilsbøll, F K Knop
Compared with bariatric surgery, less invasive and reversible techniques to counteract obesity and type 2 diabetes (T2D) have been developed, including the EndoBarrier Gastrointestinal Liner [duodenal-jejunal bypass sleeve (DJBS)]. We conducted a systematic review and meta-analyses of eligible trials to evaluate the efficacy and safety of the DJBS. Five randomized controlled trials (RCTs; 235 subjects) and 10 observational studies (211 subjects) were included. The risk of bias was evaluated as high in all studies...
March 2016: Diabetes, Obesity & Metabolism
Deepanshu Jain, Shashideep Singhal
Obesity is a rapidly growing pandemic. Scope of pharmacotherapy and bariatric surgery in managing obesity is ever rising. The role of minimally invasive techniques to achieve preoperative weight loss and improve postbariatric surgery outcomes is an area of new interest. The initial experience with endobarrier devices in achieving weight loss among obese subjects has shown promising results. In addition, the impact of these interventions on comorbidities commonly associated with obesity like diabetes mellitus type 2 and hyperlipidemia has further expanded their potential for use in future...
November 2015: Journal of Clinical Gastroenterology
Nitin Kumar
A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, space-occupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo OverStitch, TransOral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device...
July 25, 2015: World Journal of Gastrointestinal Endoscopy
Ulrich Rohde, Cecilie A Federspiel, Peter Vilmann, Steffen U Friis, Ebbe Langholz, Tina Vilsbøll, Filip K Knop
No abstract text is available yet for this article.
2015: Endoscopy
Eduardo Espinet-Coll, Jordi Pujol-Gebelli, Amador García-Ruiz-de-Gordejuela, Anna Casajoana-Badia, Javier Nebreda-Durán, Antonio Juan-Creix-Comamala, José Antonio Gómez-Valero, Carmen Vila-Lolo
No abstract text is available yet for this article.
March 2015: Revista Española de Enfermedades Digestivas
Eduardo Guimarães Hourneaux de Moura, Guilherme Sauniti Lopes, Bruno Costa Martins, Ivan Roberto Bonotto Orso, Artur Martins Novaes Coutinho, Suzana Lopes de Oliveira, Paulo Sakai, Manoel dos Passos Galvão-Neto, Marco Aurélio Santo, Marcelo Tatit Sapienza, Ivan Cecconello, Carlos Alberto Buchpiguel
INTRODUCTION: The duodenal-jejunal bypass liner (DJBL) is a promising technique for treating obesity and type 2 diabetes mellitus (T2DM). However, despite promising results, its mechanism of action has not been elucidated. It is thought to promote changes in gastric emptying owing to the neuro-endocrine axis. OBJECTIVE: The aim of this paper was to study DJBL-induced changes in gastric emptying and the relationship of those changes with weight loss and T2DM. METHODS: Twenty-five patients with obesity and T2DM met inclusion criteria...
September 2015: Obesity Surgery
Claudia Läßle, Katharina Laubner, Henning Schwacha, Jochen Seufert, Jodok Matthias Grueneberger, Andreas Fischer, W Konrad Karcz, Ulrich T Hopt, Goran Marjanovic, Simon Kuesters
No abstract text is available yet for this article.
2014: Endoscopy
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