Endoscopy 2018; 50(01): 14-21
DOI: 10.1055/s-0043-120439
Original article
© Georg Thieme Verlag KG Stuttgart · New York

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

Robert Caiazzo*, 1, 2, Julien Branche*, 1, 2, Mehdi Daoudi1, 3, Gilles Solecki3, Thomas Hubert1, Audrey Quenon1, Violeta Raverdy1, 2, François Cousin3, François Henin3, Valery Dalle3, Stéphane Noel3, Geoffroy Vanbiervliet4, Marc Barthet4, François Pattou1, 2
  • 1University of Lille, Lille; INSERM 1190, European Genomics Institute for Diabetes (EGID), Lille, France
  • 2Centre Hospitalier Régional Universitaire, Lille, France
  • 3Cousin Biotech, Wervicq, France
  • 4Department of Gastroenterology, Public Assistance Hospitals of Marseille, Marseille, France
Further Information

Publication History

submitted 10 August 2016

accepted after revision 17 July 2017

Publication Date:
01 December 2017 (eFirst)


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).

Results 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.

* These authors contributed equally to this work.