Endoscopy for Metabolic Diseases

作者：Maria Valeria Matteo, Jana Kefah Ibrahim Hussein, G. Carlino, Vincenzo Bove, Valerio Pontecorvi, Loredana Gualtieri, Martina De Siena, Mariachiara Di Vincenzo, Lorenzo Zileri Dal Verme, Daniele Salvi, Clarissa Ferrari, Cristiano Spada, Ivo Boškoski · 发表于：Journal of Clinical Medicine · 年份：2026 · DOI：10.3390/jcm15082832 · 研究领域：Bariatric Surgery and Outcomes、Gastrointestinal motility and disorders、Food composition and properties

Endoscopic bariatric and metabolic therapies (EBMTs) offer minimally invasive treatment options for obesity and related metabolic disorders such as type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD). These therapies are broadly categorized into gastric and small bowel interventions. Gastric EBMTs, including intragastric balloons and endoscopic sleeve gastroplasty, promote weight loss primarily through mechanical restriction and delayed gastric emptying, thereby improving metabolic outcomes. Small bowel therapies target the proximal intestine to modulate nutrient-sensing and hormonal pathways, providing metabolic benefits that may occur independently of weight loss. Techniques such as duodenal mucosal resurfacing, electroporation-based re-cellularization, and duodenal-jejunal bypass liners demonstrate promising effects on glycemic control, insulin sensitivity, and liver health. Emerging technologies utilizing thermal, vapor, and laser ablation further expand therapeutic possibilities. While these interventions show favorable safety profiles and potential as standalone or adjunctive treatments, further long-term studies and randomized trials are necessary to optimize patient selection and procedural protocols. Collectively, EBMTs represent an evolving paradigm in the management of obesity and metabolic diseases, bridging the gap between conservative medical therapies and bariatric surgery.