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

BACKGROUND: 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. METHODS: 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. 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. CONCLUSIONS: 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.