Endoscopic intragastric balloon therapy for 15 years in Japan: Results of nationwide surveys

Abstract

Introduction Endoscopic intragastric balloon (IGB) placement has been performed in Japan since 2004. The nationwide surveys were repeatedly carried out to confirm the effectiveness and safety of IGB in Japan. We herein present the accumulated results. Methods Twenty‐six Japanese endoscopists personally imported products of the BioEnterics Intragastric Balloon (BIB)/Orbera system after completing the training courses in Japan. Mail surveys were posted to them every 2 years from 2010. This study included the accumulated data of the six surveys, and excluded data from non‐Japanese patients and the Orbera365 data. Results Between 2004 and 2019, 399 obese Japanese patients underwent IGB treatment using the BIB/Orbera system. The incidence rates of early removal of IGB within 1 week and complications due to IGB were 4.8% and 6.1%, respectively. The average percent excess weight loss (%EWL) and percent total weight loss (%TWL) at IGB removal were 46.6% and 11.5%, and successful weight loss, defined as %EWL ≥ 25% or %TWL ≥ 10%, was achieved in 65.6% or 54.5% of the patients, respectively. Multivariate analyses revealed that older age and larger saline filling volume were independent predictors of successful weight loss. At 1 year after IGB removal, successful weight loss defined by the %EWL and %TWL was maintained in 44.7% and 34.1% of the patients, respectively. Conclusion IGB therapy using the BIB/Orbera system has been safely and effectively performed in Japan. The successful weight loss may be associated with older age and larger saline filling volume.

Factors of Affecting the Success of Intragastric Balloon

“…Similar to our study, it was reported that weight loss after sleeve gastrectomy was less in the older population than in the young population. 25 However, in the study by Ohta et al, 20 contrary to our results, it has been reported that the success of IGB application was higher in older people. In the study of Diab AF et al, 14 the rate of % EWL after IGB application in women under 40 years of age was higher than those over 50 years of age; however, similar results have been shown in men over the age of 40 and under the age of 50.…”

“…There is a wide range of data in the literature on the success of IGB. Whereas the success rate was 65.6% in the study of Ohta et al, 20 it was reported as 93% in the study of Fittipaldi-Fernandez RJ et al 11 In our study, the mean age was higher in those who could not achieve sufficient weight loss in 6 months. Studies have revealed that as age progresses, energy requirement and lipolytic activity decrease.…”

“…There is a wide range of data in the literature on the success of IGB. Whereas the success rate was 65.6% in the study of Ohta et al,20 it was reported as 93% in the study of Fittipaldi-Fernandez RJ et al11…”

How effective is intragastric balloon insertion as an obesity treatment in Korea?

“…One year after IGB removal, successful weight loss, defined in terms of %EWL and %TWL, was maintained in 44.7% and 34.1% of the patients, respectively. 6 In an Egyptian study conducted among 1,600 patients with a BMI of ≥25 kg/m 2 , the average %EWL and %TWL were 50.1% and 25.6%, respectively. There was a statistically significant difference in HbA1c and blood pressure before and after intervention.…”