Objective To investigate the mechanisms of action, clinical efficacy, safety, and current applications of the duodenal-jejunal bypass liner (DJBL) in endoscopic bariatric treatment, and to provide references for treatment decision-making in patients with obesity. MethodsThe relevant literature on DJBL in recent years was summarized. ResultsWeight-loss and metabolic benefits of DJBL may be associated with isolation of the proximal small intestinal mucosa, changes of incretin secretion, bile acid metabolism, and gut microbiota. DJBL shows certain effects on weight reduction and glycemic improvement during the implantation period, however its efficacy is influenced by device type, implantation duration, and study population. Clinical studies of domestic gastric diversion stent systems have also demonstrated short-term weight-loss effects. Main limitations of DJBL include device migration, gastrointestinal intolerance, liver abscess, and insufficient maintenance of therapeutic effects after device removal. ConclusionsAs a reversible endoscopic bariatric technology, DJBL provides a potential treatment option for selected patients who are unwilling or unsuitable for surgical bariatric procedures. Further multicenter, long-term clinical studies are required to define the suitable crowd and to evaluate its long-term benefits and risk management strategies.
