Koehestanie P, Betzel B, Aarts E O, Janssen I M C, Wahab P, Berends F J
Department of Surgery, Rijnstate Hospital, the Netherlands.
Department of Surgery, Rijnstate Hospital, the Netherlands.
Surg Obes Relat Dis. 2015 Sep-Oct;11(5):1099-104. doi: 10.1016/j.soard.2015.01.016. Epub 2015 Feb 9.
The endoscopic ally implanted DJBL is a 60-cm impermeable fluoropolymer device, which prevents food from making contact with the proximal intestine. It was designed to induce weight loss and treat type 2 diabetes mellitus (T2DM).
To evaluate the feasibility, safety, and effectiveness of duodenal-jejunal bypass liner (DJBL) reimplantation.
Prospective, observational study was conducted at the department of surgery and gastroenterology of the Rijnstate hospital, Arnhem, the Netherlands, between 2009 and 2011.
Five obese patients with T2DM with body mass index (BMI) = Mass (kg) / height (m(2)), ranging from 30-35 kg/m(2) who completed the follow-up after their first implant and underwent removal of the DJBL after 6 months, were selected for reimplantation after an additional 18 months of follow-up. Weight loss, BMI, and HbA1 c were analyzed before and twelve months after reimplantation.
In all 5 patients, the DJBL was implanted and explanted without any complications. Also the reimplantation and reexplantation occurred without any complications. Median weight decreased significantly from 105 kg to 95 kg, and BMI decreased from 33 to 29. The glycated hemoglobin (HbA1 c) level decreased from 8.4% to 7.3% by the first implantation but it wasn't significant.
Reimplantation of DJBL is feasible, deemed safe, and showed additional weight loss.
内镜植入的十二指肠空肠旁路衬管（DJBL）是一种60厘米长的不可渗透含氟聚合物装置，可防止食物与近端肠道接触。它旨在诱导体重减轻并治疗2型糖尿病（T2DM）。
评估十二指肠空肠旁路衬管（DJBL）再次植入的可行性、安全性和有效性。
2009年至2011年期间，在荷兰阿纳姆市莱茵斯塔特医院的外科和胃肠病科进行了一项前瞻性观察研究。
选择5名T2DM肥胖患者，其体重指数（BMI）=体重（千克）/身高（米²），范围为30 - 35千克/米²，这些患者在首次植入后完成随访，并在6个月后取出DJBL，在额外随访18个月后进行再次植入。分析再次植入前和植入后十二个月的体重减轻情况、BMI和糖化血红蛋白（HbA1c）。
所有5名患者植入和取出DJBL均无任何并发症。再次植入和再次取出也未出现任何并发症。中位数体重从105千克显著降至95千克，BMI从33降至29。糖化血红蛋白（HbA1c）水平在首次植入时从8.4%降至7.3%，但不显著。
DJBL再次植入是可行的，被认为是安全的，并且显示出额外的体重减轻。
