Abstract
Bariatric surgery has experienced a dramatic evolution over the last years. The search for less invasive procedures to improve the benefit/risk ratio and to expand the benefits of these interventions to a larger group of patients has led to the development of primary endoscopic procedures for the treatment of obesity and its associated diseases. The duodenal-jejunal bypass liner (DJBL) is a highly flexible and impermeable tube that can be endoscopically implanted and explanted. It is specifically designed to create a duodenal-jejunal exclusion. The DJBL treatment has now become a primary intervention for the treatment of morbid obesity and to improve glycemic control in obese patients with type 2 diabetes mellitus (T2DM). Available evidence supports the role of DJBL in treating obesity and improving glycemic control in a significant proportion of severely obese diabetic patients. Early removal and a higher rate of serious adverse events in clinical practice are the most important limitations in terms of safety. Randomized clinical trials are needed to evaluate the safety/efficacy ratio of the procedure and its clinical use in future.
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