6 Committee comments
6.1 The Committee considered that the quality of randomised controlled trials was poor, with substantial loss of patients to follow-up and potential for bias.
6.2 The Committee was advised that appropriate indications for implantation of a duodenal–jejunal bypass sleeve (DJBS) are uncertain. The specialist advisers stated that it might be used for improvement of control of diabetes in patients with obesity (but not in patients with diabetes who are not obese); for weight loss alone (but the durability of its effects may be limited); or for weight reduction before planned bariatric surgery. The literature reported heterogeneous outcomes relevant to these various indications, and also reported improvements in control of hypertension and blood lipid levels. The Committee was also advised that the device used in some of the studies was a prototype rather than a device that has been introduced into clinical practice.
6.3 The Committee noted specialist advice that this procedure should only be used in units specialising in the treatment of obesity, as one of a range of treatment options and as part of a package of care.