# Ten Year Follow-Up After Explantation of the Duodenal-jejunal Bypass Liner

## TL;DR

This study shows that the benefits of a duodenal-jejunal bypass liner for weight and diabetes management last up to 10 years, but additional surgery improves outcomes further.

## Contribution

The study provides the first 10-year follow-up data on DJBL effects and evaluates the role of subsequent metabolic bariatric surgery.

## Key findings

- Weight, BMI, and HbA1c levels remained significantly improved 10 years after DJBL explantation.
- Metabolic bariatric surgery after DJBL led to greater weight loss and better diabetes control.
- GLP-1 agonists use was linked to higher BMI but did not improve diabetes or quality of life outcomes.

## Abstract

The duodenal-jejunal bypass liner (DJBL) is a treatment for weight loss and diabetes management. While its short-term benefits are known, long-term outcomes of this endoscopic procedure remain largely unknown. This study investigates the long-term effects of DJBL placement on weight, diabetes, and quality of life (QoL) over a period of approximately 10 years post-explantation.

A cross-sectional follow-up study was conducted in 103 former DJBL patients who had DJBL implantation (also known as the Endobarrier) between 2011 and 2014. Participants completed a questionnaire assessing their health, weight, lifestyle, diabetes control, and QoL. Data were compared to original cohort results.

After approximately 10 years, weight, BMI, and HbA1c levels remained significantly improved compared to the time of DJBL explantation (p < 0.05). Of the respondents, 33 (32%) had undergone metabolic bariatric surgery (MBS) post-explantation, with significant reductions in weight and BMI observed in this group. MBS was associated with better diabetes control and higher QoL scores compared to non-MBS patients. No significant differences in diabetes-related complications were seen between the MBS and non-MBS groups. GLP-1 agonists use was associated with a higher BMI but did not significantly affect weight, diabetes control, or QoL outcomes.

Although DJBL treatment has some sustained benefits regarding weight and diabetes management, these effects are limited without further weight-reducing interventions. MBS following DJBL explantation leads to more substantial weight loss and improved diabetes outcome, highlighting its complementary role after DJBL treatment.