The Effectiveness and Safety of the Duodenal-Jejunal Bypass Liner (DJBL) for the Management of Obesity and Glycaemic Control: a Systematic Review and Meta-Analysis of Randomized Controlled Trials

Obes Surg. 2023 Feb;33(2):585-599. doi: 10.1007/s11695-022-06379-0. Epub 2022 Dec 12.

Abstract

Introduction: The duodenal-jejunal bypass liner (DJBL) is a less-invasive treatment of obesity and type 2 diabetes mellitus (T2DM).

Methods: This is a systematic review and meta-analysis including randomized clinical trials (RCTs) comparing DJBL versus sham or pharmacotherapies aiming to evaluate the effectiveness and safety of DJBL.

Results: Ten RCTs (681 patients) were included. The DJBL group showed superior excess weight loss (+ 11.4% [+ 7.75 to + 15.03%], p < 0.00001) and higher decrease in HbA1c compared to the control group (- 2.73 ± 0.5 vs. - 1.73 ± 0.4, p = 0.0001). Severe adverse events (SAEs) occurred in 19.7%.

Conclusion: The DJBL did not reach the ASGE/ASMBS thresholds for the treatment of obesity. However, it is important to state that many SAEs were not really severe. Therefore, we believe this therapy plays an important role in the management obesity and T2DM.

Keywords: Bariatric surgery; Diabetes; Duodenal-jejunal bypass liner; Endoscopy; Glycaemic control; Meta-analysis; Obesity; Systematic review; Weight Loss.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Bariatric Surgery* / adverse effects
  • Diabetes Mellitus, Type 2* / etiology
  • Duodenum / surgery
  • Humans
  • Jejunum / surgery
  • Obesity / etiology
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Randomized Controlled Trials as Topic
  • Treatment Outcome