Safety and efficacy of the duodenal-jejunal bypass liner for treatment of obesity and diabetes
Year: 2019
Type: dissertation
Abstract: Chapter 1 Chapter 1Part A, on the efficacy of the DJBL, consist of 4 chapters.Chapter 2 describes the effects of the DJBL on type 2 diabetes, obesity and other cardiovascular parameters during an intended 12 month implantation time in a large observational prospective cohort study.In addition, we address the number and causes of early explantations and accompanying AEs related to the treatment.Finally, we defined predictive factors for success of treatment.Chapter 3 presents a multi-center cross-over study in which patients first received a dietician supported diet during 6 months which was followed by DJBL treatment for 6-12 months.This study design made it possible to have patients treated with the DJBL to be their own controls, comparing their outcomes with the dietary period.After removal of the device, patients were followed for an additional 6 month period.Chapter 4 addresses an important aspect of a technique that is temporarily of nature: the durability of the gained effects after removal of the DJBL.This chapter describes changes in body weight, glucose control and other cardiovascular parameters until 1 year after explantation.In Chapter 5, the last part of the efficacy of the DJBL, results are shown of patients who underwent an extended implantation time of up to 24 months.Besides efficacy, early removals and AEs are elaborated.Part B, safety aspects of the DJBL, is introduced by Chapter 6, a systematic review presenting all AEs in literature.This systematic review classified the AEs systematically and determined in all articles quality of reporting of the AEs.Chapter 7a provides a short introduction and rationale to the following chapters.Chapter 7b considers the safety profile of the DJBL and shows a wide variety of AEs and provides basic advices how to recognize and manage these AEs.A frequently and potentially severe AE, acute pancreatitis, is elaborated in Chapter 7c.This case series describes 5 cases of acute pancreatitis in patients treated with the DJBL and the assumed etiology.Chapter 7d, the last of part B, contains an illustrative atlas of the normal situation after placement and AEs that are related to the treatment of the DJBL.
Author: Bark Betzel
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2945264824