Effect of the EndoBarrier Gastrointestinal Liner on obesity and type 2 diabetes: a systematic review and meta-analysis

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2016-03, Vol.18 (3), p.300-305
• Main Authors: Rohde, U., Hedbäck, N., Gluud, L. L., Vilsbøll, T., Knop, F. K.
• Format: Article
• Language: English
• Subjects: Abdominal Pain - etiology; Adult; Blood Glucose - analysis; Body Mass Index; Body weight loss; cholesterol; Confidence intervals; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - surgery; duodenal-jejunal bypass sleeve (DJBS); Duodenum - surgery; EndoBarrier gastrointestinal liner; Fasting - blood; fasting plasma glucose; Female; Gastrointestinal surgery; Glycated Hemoglobin A - analysis; HbA1c; Hemoglobin; Humans; Jejunoileal Bypass - adverse effects; Jejunoileal Bypass - instrumentation; Jejunoileal Bypass - methods; Jejunum - surgery; Male; Meta-analysis; Middle Aged; Nausea - etiology; Obesity; Obesity - complications; Obesity - surgery; Observational Studies as Topic; Randomized Controlled Trials as Topic; review; safety; Systematic review; Treatment Outcome; type 2 diabetes; Vomiting - etiology; Weight control; Weight Loss
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.12603

Compared with bariatric surgery, less invasive and reversible techniques to counteract obesity and type 2 diabetes (T2D) have been developed, including the EndoBarrier Gastrointestinal Liner [duodenal‐jejunal bypass sleeve (DJBS)]. We conducted a systematic review and meta‐analyses of eligible trials to evaluate the efficacy and safety of the DJBS. Five randomized controlled trials (RCTs; 235 subjects) and 10 observational studies (211 subjects) were included. The risk of bias was evaluated as high in all studies. The mean body mass index ranged from 30 to 49.2 kg/m2 and 10–100% of the subjects had T2D. Meta‐analysis showed that the DJBS was associated with significant mean differences in body weight and excess weight loss of −5.1 kg [95% confidence interval (CI) −7.3, −3.0; four trials; n = 151; I2 = 37%] and 12.6% (95% CI 9.0, 16.2; four trials; n = 166; I2 = 24%), respectively, compared with diet modification. The mean differences in glycated haemoglobin (−0.9%; 95% CI −1.8, 0.0) and fasting plasma glucose (−3.7 mM; 95% CI −8.2, 0.8) among subjects with T2D did not reach statistical significance. Adverse events consisted mainly of abdominal pain, nausea and vomiting. No deaths occurred. Future high‐quality long‐term RCTs are needed to further assess efficacy and safety.