Background

The duodenal-jejunal bypass liner (DJBL) is a device approved for treatment of obesity. The aim of this study is to describe the short term weight loss with DJBL and long term weight change after the device removal.

Methods

This is a combined prospective data collection and retrospective chart review of all patients who had DJBL inserted at the University hospital of Zurich between December 2012 and June 2015.

Results

A total of 27 patients were included in this study. Baseline characteristics are shown in table 1. The mean BMI at baseline was 41 + 10 kg/m2. One patient had a failed implantation due to anatomical problems and two patients had early explantation so they were excluded from the analysis of weight change. Of the remaining 24 patients, the mean duration of implantation was 42.9 weeks (SD = 13.1). During the treatment, the mean total body weight loss (TBWL) was 16.6 kg (SD = 13.5, range 0-58 kg) and the mean % total body weight loss (%TBWL) was 15.0% (SD = 8.3, range 0-34%).Mean %TBWL during the treatment with DJBL were 7.6+3.9%, 11.3+5.2%, 13.5+8.9 and 15.0+8.4% at 3, 6, 9 and 12 months, respectively (figure 1).Twenty-one patients (87.5%) lost at least 5% of their body weight, 17 patients (70.8%) lost at least 10% of their body weight and 11 patients (45.8%) lost at least 15% of their body weight (figure 2).Fifteen patients had long-term follow-up data available. The mean duration of follow-up were 3.97 years (SD = 0.9, range 2.8-5.5 years). The mean weight change was 12.7 kg (SD = 12.8, range -8-52kg), corresponding with a mean % weight regain of 13.3% (SD = 13.3, range -9.8-48.1%). Five patients (33.3%) subsequently underwent a bariatric surgery procedure (4 Roux-en-Y gastric bypass, 1 sleeve gastrectomy) at 3-5 years later.

Conclusions

DJBL is an effective treatment for obesity but substantial weight regain occurs during long-term follow up after the device removal. Additional intervention maybe required for weight maintenance after device explantation.