内镜十二指肠空肠旁路衬垫在肥胖控制和血糖控制中的作用。

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY
Clinical Endoscopy Pub Date : 2024-05-01 Epub Date: 2024-02-15 DOI:10.5946/ce.2023.217
Willian Ferreira Igi, Victor Lira de Oliveira, Ayah Matar, Diogo Turiani Hourneaux de Moura
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引用次数: 0

摘要

肥胖症及其并发症的治疗方法多种多样,从改变生活方式和服用药物的临床管理,到减肥和新陈代谢手术。最近出现的各种内窥镜减肥和代谢疗法(EBMT)提供了一种比保守疗法更有效的微创手术替代疗法,填补了重要的治疗空白。本文全面回顾了最具前景的 EBMT 之一--十二指肠空肠旁路衬垫(DJBL)--的技术方面、作用机制、疗效和未来展望。DJBL 模仿 Roux-en-Y 胃旁路术的机制,阻止食物与十二指肠和空肠近端接触,从而引发一系列激素变化,导致胃排空延迟和吸收不良。这些生理变化导致体重明显减轻,代谢控制得到改善,从而提高血糖水平,预防血脂异常和非酒精性脂肪肝,并降低心血管风险。然而,由于严重不良事件报告率较高,尤其是肝脓肿,人们对该设备的安全性表示担忧。目前正在对临床试验中旨在减少不良事件的技术变革进行评估,这些变革可能会提供更可靠的数据,以支持其在临床实践中的常规使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control.

The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariat-ric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article compre-hensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern ex-ists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongo-ing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to sup-port its routine use in clinical practice.

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来源期刊
Clinical Endoscopy
Clinical Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
8.00%
发文量
95
审稿时长
26 weeks
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