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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: Ten normal glucose tolerant (NGT) obese subjects and nine 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 one (1w) and 26 weeks (26w) after implantation...
October 3, 2016: 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...
July 28, 2016: 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 Michaela Ignat, Michel Vix, Lee L Swanstrom
No abstract text is available yet for this article.
June 13, 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
Ulrich Rohde, Nora Hedbäck, Lise L Gluud, Tina Vilsbøll, Filip K Knop
INTRODUCTION: Obese patients with type 2 diabetes undergoing bariatric surgery experience significant and lasting weight loss and improved glycaemic control. However, bariatric surgical procedures such as Roux-en-Y gastric bypass are irreversible and associated with considerable short-term and long-term risks. The EndoBarrier Gastrointestinal Liner or duodenal-jejunal bypass sleeve (DJBS) is a fully reversible procedure that has been developed to treat obesity and type 2 diabetes. We aim to perform a systematic review and meta-analysis of safety and efficacy of DJBS...
2013: BMJ Open
Parviez Koehestanie, Bark Betzel, Kemal Dogan, Frits Berends, Ignace Janssen, Edo Aarts, Marcel Groenen, Peter Wahab
BACKGROUND: The endoscopically placed duodenal-jejunal bypass liner (DJBL) or EndoBarrier gastrointestinal liner has been designed for the treatment of type 2 diabetes mellitus and simultaneous achievement of weight loss by obese patients. This study was performed to determine the safety, efficacy, and feasibility of delivering the DJBL with the patient under conscious sedation (CS). The primary end points of the study were safety and complications. The secondary end points were delivery time (min), amount of propofol (mg) used, and the total hospital stay (h)...
January 2014: Surgical Endoscopy
Shaneel R Patel, John Mason, Nadey Hakim
No abstract text is available yet for this article.
August 2012: Indian Journal of Surgery
Shaneel R H Patel, David Hakim, John Mason, Nadey Hakim
BACKGROUND: Surgical intervention is now the most effective modality with which to treat severe obesity. There is currently a lack of minimally invasive technology with which we can effectively treat obesity and reverse type 2 diabetes mellitus. The EndoBarrier is a fluoropolymer sleeve that is reversibly fixated to the duodenal bulb and extends 80 cm into the small bowel, usually terminating in the proximal jejunum. This endoscopically inserted device aids weight loss through malabsorption and activating hormonal triggers...
May 2013: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
E M H Mathus-Vliegen
The EndoBarrier, an endoscopically delivered duodeno-jejunal bypass device, is a unique concept that starts to ameliorate the symptoms of diabetes mellitus type 2, soon after positioning. Weight-loss results are moderate, with 85% of patients showing a more than 10% excess weight loss in the 12 weeks preoperatively. Sufficient implant training is required, but problems can still occur, e.g., due to a short duodenal bulb length. The stability of the anchors and the tolerability of the device still leave much to be desired...
2012: Nederlands Tijdschrift Voor Geneeskunde
Froukje J Verdam, Paulien R Liedorp, Noëlle Geubbels, Ruben Schouten, Ignace M C Janssen, Ger H Koek, Jan Willem Greve
The prevalence of obesity is increasing worldwide. Its primary treatment consists of lifestyle changes. In severely obese (BMI > 40 kg/m2 or ≥ 35 kg/m2 with comorbidity) patients though, bariatric surgery has been found to be the only way to achieve permanent weight loss. Operations such as the placement of a gastric band or a gastric bypass can, however, lead to complications and necessitate secondary interventions. In search of less invasive treatments, placement of the EndoBarrier duodenal jejunal bypass liner appears to be a promising, safe and effective method for facilitating weight loss...
2012: Nederlands Tijdschrift Voor Geneeskunde
Eduardo Espinet-Coll, Javier Nebreda-Durán, José Antonio Gómez-Valero, Miguel Muñoz-Navas, Jordi Pujol-Gebelli, Carmen Vila-Lolo, Antonio Martínez-Gómez, Antonio Juan-Creix-Comamala
BACKGROUND: in recent years new endoscopic strategies and techniques for the treatment of obesity have emerged and developed. AIM OF THE STUDY: in this article we will review and analyze the current state of the following techniques and the basic differential characteristics between each of them: balloons and prosthesis, injection of substances, systems of sutures, malabsorptives techniques and others currently in research. METHODS: we will evaluate the endoscopic technique and their main indications, results, tolerances, complications and adverse effects observed, reporting our personal experience and in relation with an extensive literature review...
February 2012: Revista Española de Enfermedades Digestivas
Keith S Gersin, Richard I Rothstein, Raul J Rosenthal, Dimitrios Stefanidis, Stephen E Deal, Timothy S Kuwada, William Laycock, Gina Adrales, Melina Vassiliou, Samuel Szomstein, Stephen Heller, Anne Marie Joyce, Frederick Heiss, Dmitry Nepomnayshy
BACKGROUND: The duodenojejunal bypass liner (DJBL) (EndoBarrier Gastrointestinal Liner) is an endoscopically placed and removable intestinal liner that creates a duodenojejunal bypass resulting in weight loss and improvement in type 2 diabetes mellitus. OBJECTIVE: Weight loss before bariatric surgery to decrease perioperative complications. DESIGN: Prospective, randomized, sham-controlled trial. SETTING: Multicenter, tertiary care, teaching hospitals...
May 2010: Gastrointestinal Endoscopy
Ruben Schouten, Carianne S Rijs, Nicole D Bouvy, Wim Hameeteman, Ger H Koek, Ignace M C Janssen, Jan-Willem M Greve
BACKGROUND: The endoscopically placed duodenal-jejunal bypass sleeve or EndoBarrier Gastrointestinal Liner has been designed to achieve weight loss in morbidly obese patients. We report on the first European experience with this device. METHODS: A multicenter, randomized clinical trial was performed. Forty-one patients were included and 30 underwent sleeve implantation. Eleven patients served as a diet control group. All patients followed the same low-calorie diet during the study period...
February 2010: Annals of Surgery
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