Verlagslink DOI: 10.1016/j.soard.2018.02.029
Titel: Longitudinal evaluation of efficacy, safety and nutritional status during one-year treatment with the duodenal-jejunal bypass liner
Sprache: Englisch
Autorenschaft: Riedel, Nina 
Laubner, Katharina 
Lautenbach, Anne 
Schön, Gerhard 
Schlensak, Matthias 
Stengel, Rainer 
Eberl, Thomas 
Dederichs, Frank 
Aberle, Jens 
Seufert, Jochen 
Erscheinungsdatum: Jun-2018
Zeitschrift oder Schriftenreihe: Surgery for Obesity and Related Diseases 
Zeitschriftenband: 14
Zeitschriftenausgabe: 6
Anfangsseite: 769
Endseite: 779
Zusammenfassung: 
Abstract

Background: The endoscopic duodenal-jejunal bypass liner (DJBL) represents a novel temporary endoscopic approach for treatment of obesity-associated type 2 diabetes. Recent results from the German DJBL registry confirmed substantial positive metabolic effects of the DJBL in type 2 diabetes. However, the last Food and Drug Administration trial was stopped due to a high occurrence of hepatic abscesses (3.5%).

Objectives: Here, we analyzed time courses of development of co-morbidities, nutritive changes, and occurrence of adverse events during the 1-year treatment phase with the DJBL in the German DJBL registry.

Methods: Sixty-six patients from the registry were analyzed for efficacy, safety, and nutritional status. Patient data sets were analyzed at implantation, 3 and 6 months after implantation, and at explantation visits.

Results: Weight, body mass index, glycated hemoglobin, and low-density lipoprotein cholesterol primarily declined during the first 3 months after implantation, whereas systolic and diastolic blood pressure were predominantly reduced during the second half of the treatment phase. Severe DJBL-associated side effects were mainly documented at the explantation visit (intestinal obstruction [1.7%], dislocation [1.7%], and liver abscess [1.7%]). Measurements of serum concentrations of ferritin, albumin, vitamin B12, folic acid, 25-hydroxyvitamin D3 (25 OH-Vit-D3), and calcium provided suggestive evidence of a possible decrease of nutritional absorption of vitamins and trace elements by the DJBL.

Conclusions: The DJBL demonstrates high efficacy with substantial improvement of all parameters of the metabolic syndrome and the potential for reduction of comedications in overweight patients with type 2 diabetes. These registry results are important to optimize recommendations for adaptation of concomitant medication, surveillance of adverse events, nutritional status and supplementation, and adaptation of the implantation period of the DJBL.

[Epub 2018 Mar 9]
URI: http://hdl.handle.net/20.500.12738/4567
Einrichtung: Department Ökotrophologie 
Fakultät Life Sciences 
Dokumenttyp: Zeitschriftenbeitrag
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