Brazilian Intragastric Balloon Consensus Statement (BIBC): practical guidelines based on experience of over 40,000 cases

Neto, Manoel Galvao; Silva, Lyz Bezerra; Grecco, Eduardo; Quadros, Luiz Gustavo de; Teixeira, André; Souza, Thiago Ferreira de; Scarparo, Jimi; Parada, Artur Adolfo; Dib, Ricardo; Moon, Rena; Campos, Josemberg Marins

doi:10.1016/j.soard.2017.09.528

Cited by 108 publications

(63 citation statements)

References 12 publications

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“…The incidence of early balloon removal was 11.7%. Removal due to intolerance was more prevalent among the patients using NIBs (7.4%); the literature estimates an incidence of 2%-7% (13,17,(27)(28)(29) . The lower incidence of premature removal caused by intolerance registered for patients with adjustable balloons (1.7%) is likely due to the fact that this type of balloon can be adjusted to lessen any gastrointestinal symptoms that arise.…”

Section: Discussionmentioning

confidence: 97%

Assessment of Weight Loss After Non-Adjustable and Adjustable Intragastric Balloon Use

Schwaab

Usuy

Albuquerque

et al. 2020

Arq. Gastroenterol.

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BACKGROUND: Intragastric balloon (IGB) use is indicated for patients whose BMI precludes the option of bariatric surgery or who need to lose weight prior to undergoing surgery. It is a minimally invasive procedure and currently there are two main models of IGBs in use, the non-adjustable intragastric balloon (NIB), implanted for six months, and the adjustable intragastric balloon (AIB), implanted for up to 12 months. OBJECTIVE: Analyze clinical characteristics between patients receiving non-adjustable gastric balloon and the adjustable (prolonged implantation) intragastric balloon. METHODS: This was a cross-sectional study of 470 patients diagnosed as obese or overweight who had balloon implantation from October 2011 to July 2018. The associations between percentage excess weight loss versus clinical and demographic variables were calculated using the chi-squared test. Independent samples were submitted to the Student’s t test to determine the quantitative variables, with a confidence interval of 95%. Calculation of excess weight was based on an estimated ideal weight that would correspond to a BMI of 24.99 kg/m2. RESULTS: A total of 414 patients completed the treatment achieving an average total body weight loss (%TBWL) of 15.4±7 with the NIB and 15.5±9.6 with the AIB. Overweight patients achieved higher excess weight loss (%EWL) values using AIBs (157.2±82.5) and obese patients did so with NIB use (56±29.7). Women achieved higher %EWL values (65.6±62.2) than men (48±27.1). Individuals who attended >4 consultations with a nutritionist (60.8%) achieved TBWL >18%. All of those P-values were <0.001. CONCLUSION: Obese individuals and women registered the greatest weight losses. Overweight patients achieved greater losses using AIB and obese patients did so using NIBs. NIB use was associated with higher EWL percentages. Nutritional accompaniment had a positive impact on the %TBWL.

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Section: Discussionmentioning

confidence: 97%

Assessment of Weight Loss After Non-Adjustable and Adjustable Intragastric Balloon Use

Schwaab

Usuy

Albuquerque

et al. 2020

Arq. Gastroenterol.

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“…At least 31 consensus statements from multiple countries that relate to treatment of diseases comorbid with obesity have been issued, featuring topics such as indications for bariatric metabolic surgery, bariatric endoscopy, robotic bariatric surgery, bariatric nutrition, childhood obesity, and quality of life. Consensus statements and guidelines for individual bariatric procedures have been published by independent surgical working groups [15][16][17][18][19][20], country-specific consensus alliances [21,22], and professional surgical societies, e.g., the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) [23], the American Society for Metabolic and Bariatric Surgery (ASMBS) [24], and the European Association for Endoscopic Surgery (EAES) [25], often in conjunction with nonsurgical societies.…”

Section: Consensus Focusmentioning

confidence: 99%

“…An abundance of peer-reviewed level-1 evidence describing IGB outcomes exists, including 21 RCTs, a meta-analysis with n = 6800 from 68 studies [161], and a Use is standardized by the manufacturer's instructions. Consensus Statement (Brazilian) with n = 41,863 [22], as well as a report of a consecutive series of post-FDA patients [162].…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

“…By the metaanalysis of Abu Dayyeh et al (n = 6800, 68 studies), mortality was 0.08%, migration 1.4%, and perforation 0.1% (half in patients with prior surgery) [161]. In the recent Brazilian IGB Consensus Statement, in 41,863 IGB implants, there were 3 balloon-related deaths (0.000024%) (gastric perforation, pulmonary aspiration, and pulmonary embolism) [22]. However, a review of the literature featuring eight recent (2006-present) RCTs reported a weighted mean incidence of serious adverse events of 10.5% in the IGB group across all eight studies.…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

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Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Bhandari

Fobi

Buchwald³

2019

OBES SURG

114

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Background Standardization of the key measurements of a procedure's finished anatomic configuration strengthens surgical practice, research, and patient outcomes. A consensus meeting was organized to define standard versions of 25 bariatric metabolic procedures. Methods A panel of experts in bariatric metabolic surgery from multiple continents was invited to present technique descriptions and outcomes for 4 classic, or conventional, and 21 variant and emerging procedures. Expert panel and audience discussion was followed by electronic voting on proposed standard dimensions and volumes for each procedure's key anatomic alterations. Consensus was defined as ≥ 70% agreement. Results The Bariatric Metabolic Surgery Standardization World Consensus Meeting (BMSS-WOCOM) was convened March 22-24, 2018, in New Delhi, India. Discussion confirmed heterogeneity in procedure measurements in the literature. A set of anatomic measurements to serve as the standard version of each procedure was proposed. After two voting rounds, 22/25 (88.0%) configurations posed for consideration as procedure standards achieved voting consensus by the expert panel, 1 did not attain consensus, and 2 were not voted on. All configurations were voted on by ≥ 50% of 50 expert panelists. The Consensus Statement was developed from scientific evidence collated from presenters' slides and a separate literature review, meeting video, and transcripts. Review and input was provided by consensus panel members. Conclusions Standard versions of the finished anatomic configurations of 22 surgical procedures were established by expert consensus. The BMSS process was undertaken as a first step in developing evidence-based standard bariatric metabolic surgical procedures with the aim of improving consistency in surgery, data collection, comparison of procedures, and outcome reporting.

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“…Intragastric balloons (IGBs) are space occupying devices that are used worldwide to treat obesity and its complications 11 . Overall, IGBs have gained popularity in the last years because of their efficacy in inducing weight loss through increased satiety, with a high profile of safety 12 . IGBs are not considered as an effective treatment in the long‐term for obesity but may be helpful at least in the short‐term to improve adherence to hypocaloric regimens of obese subjects that may ‘learn’ healthy eating during the period.…”

Section: Intragastric Balloonsmentioning

confidence: 99%

Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

Salomone¹,

Sharaiha

Boškoski

2020

Liver International

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Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in industrialized countries because of the worldwide epidemic of obesity. Beyond metabolic complications, a subset of patients with NAFLD develop non-alcoholic steatohepatitis (NASH) with fibrosis, which is emerging as a leading cause of liver transplantation due to progression to cirrhosis and cancer. For these reasons, NAFLD is considered a public health burden. In recent years endoscopic bariatric and metabolic therapies (EBMT) have emerged as safe and effective for the treatment of obesity and type 2 diabetes mellitus. EBMT include gastric and duodenal devices and techniques such as intragastric balloons, endoscopic sleeve gastroplasty, endoscopic small bowel by-pass and duodenal mucosal resurfacing. Observational studies and pilot trials have revealed beneficial effects of EBMT on NAFLD as assessed by noninvasive parameters or histology. In this review we summarise current evidence for the efficacy and safety of EBMT in obese patients with NAFLD and examine future clinical applications. K E Y W O R D S bariatric endoscopy, duodenal mucosal resurfacing, endoscopic sleeve gastroplasty, intragastric balloon, NAFLD, obesity How to cite this article: Salomone F, Sharaiha RZ, Boškoski I. Endoscopic bariatric and metabolic therapies for nonalcoholic fatty liver disease: Evidence and perspectives. Liver

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Brazilian Intragastric Balloon Consensus Statement (BIBC): practical guidelines based on experience of over 40,000 cases

Abstract: The present consensus represents practical recommendations for performing IGB procedures and reflects Brazil's significant experience with this device. The experience of over 40,000 cases shows that the device leads to satisfactory weight loss with a low rate of adverse events.

Cited by 108 publications

References 12 publications

Assessment of Weight Loss After Non-Adjustable and Adjustable Intragastric Balloon Use

Assessment of Weight Loss After Non-Adjustable and Adjustable Intragastric Balloon Use

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

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