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Endoscopy. 2018 Jan;50(1):14-21. doi: 10.1055/s-0043-120439. Epub 2017 Dec 1.

Increased postprandial glucagon-like peptide-1 (GLP-1) production after endoscopic gastrointestinal bypass using the Cousin lumen-apposing stent in a porcine model.

Author information

University of Lille, Lille; INSERM 1190, European Genomics Institute for Diabetes (EGID), Lille, France.
Centre Hospitalier Régional Universitaire, Lille, France.
Cousin Biotech, Wervicq, France.
Department of Gastroenterology, Public Assistance Hospitals of Marseille, Marseille, France.
Contributed equally


BACKGROUND AND STUDY AIMS : Endoscopic techniques have demonstrated their effectiveness in metabolic surgery, notably through a gastrointestinal (GI) liner, with a less invasive approach than conventional surgery. Our study evaluates the safety and efficacy of endoscopic GI anastomosis (EGIA) using a lumen-apposing stent to secure the anastomosis. MATERIALS AND METHODS : EGIA was performed using the transgastric approach with a two-channel endoscope with a novel stent (Cousin Biotech). First, a safety study with a follow-up of 12 months was performed on five piglets. Then, metabolic changes were investigated in a minipig model (n = 10) before and after EGIA or open GIA (OGIA).


EGIA was technically successful with no complications observed during clinical monitoring. Endoscopic and postmortem examinations during the second part of study showed a secure anastomosis between the stomach and the intestinal limb in all except one minipig. Both minipigs subjected to EGIA and those in the control group (OGIA) exhibited increased postprandial glucagon-like peptide-1 (GLP-1) production (incretin secretion) and impaired D-xylose absorption (malabsorption effect). CONCLUSION : Performing EGIA with this dedicated stent appears safe, technically feasible, durable, and reproducible in providing a simple and effective endoscopic GI bypass capable of ensuring metabolic effect.

[Indexed for MEDLINE]

Conflict of interest statement

Competing interests: M Daoudi, G Solecki, F Cousin, F Henon, V Dalle, S Noel are employed by Cousin Biotech in the R and D department. R Caiazzo, J Branche, T Hubert, A Quenon, V Raverdy, G Vanbiervliet, M Barthet and F Pattou contributed to the design of the experiments, the assessment of the efficiency of the device and the procedure (in Lille university and in Marseille University). They have no conflict of interest with Cousin Biotech.

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