Endoscopic Treatment of Obesity and Nutritional Aspects of Bariatric Endoscopy

Král, J; Machytka, Evžen; Horká, Veronika; Selucká, Jana; Doleček, Filip; Špičák, Julius; Kovářová, Viktorie; Haluzı́k, Martin; Bužga, Marek

doi:10.3390/nu13124268

Cited by 12 publications

(12 citation statements)

References 81 publications

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“…Dentro del resto de modalidades de balón intragástrico, las complicaciones más comunes asociadas son: dolor abdominal, obstrucción del tracto de salida gástrico, náuseas, vómitos recurrentes, erosión esofágica y gástrica, perforación gástrica, neumonía y laringoespasmo. La pancreatitis ha sido descrita inicialmente de manera incidental, aunque ha cobrado mayor protagonismo en la última década probablemente asociado a una mayor masificación de dicho procedimiento endoscópico (1,5) . En nuestra paciente se realizaron estudios básicos sobre la etiología del cuadro de pancreatitis, para lo cual, la ecoendoscopía es considerada el mejor método de imagen para descartar causas de origen biliar (barro biliar) o alteraciones estructurales en la glándula (13,14) .…”

Section: Discussionunclassified

“…En las guías revisadas no se realizaron sugerencias sobre la posición segura para el reposo y su rol como un potencial factor precipitante para el desarrollo de pancreatitis aguda (2,3,4,5) .…”

Section: Discussionunclassified

“…Esto ha dado pie al desarrollo de la endoscopía bariátrica, incluyendo la colocación endoscópica de balón intragástrico como uno de los métodos más asequibles (1) . Esta técnica ha demostrado su efectividad como método temporal de baja de peso a través de fenómenos mecánicos y hormonales, siendo de elección como puente a cirugías bariátricas en pacientes superobesos y como terapia única en obesidad leve y sobrepeso (2,3,4,5) . Sin embargo, presenta una tasa no despreciable de efectos adversos, que alcanza hasta un 10,5% (6) ; siendo la pancreatitis aguda un evento adverso pocas veces descrito, aunque cuya incidencia aumentó notoriamente en los últimos años (7,8,2) .…”

Section: Introductionunclassified

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Pancreatitis aguda asociada a balón intragástrico

Vega

Cabrera-Hinojosa

2023

Rev Gastroenterol Peru

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Presentamos el caso de una mujer joven con el hábito de dormir en posición decúbito ventral, quien refiere que, tras la colocación de balón intragástrico, inició cuadros repetitivos de dolor abdominal en epigastrio, de aparición nocturna. El más reciente se caracterizó por dolor abdominal súbito e intenso, elevación de enzimas pancreáticas y hallazgos imagenológicos compatibles con pancreatitis aguda. Tras realizar un estudio etiológico sistemático, se descartan otras causas, retirándose el balón intragástrico con inmediato cese de los dolores nocturnos. Se atribuyó la etiología a fenómenos de compresión mecánica provocados por el balón sobre el cuerpo pancreático durante el descanso en decúbito prono. Hacemos notar que el hábito de reposo en la posición decúbito ventral constituiría un potencial factor de riesgo para pancreatitis post-colocación de balón intragástrico, por lo que este factor debe ser tomado en cuenta en la orientación de los candidatos a esta técnica.

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Section: Discussionunclassified

Section: Introductionunclassified

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Pancreatitis aguda asociada a balón intragástrico

Vega

Cabrera-Hinojosa

2023

Rev Gastroenterol Peru

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“…A maximum of 3 balloons can be placed in the stomach of a patient [ 37 ]. After a maximum of 6 months the balloons should be removed endoscopically [ 14 , 33 , 38 ]. Recently, the FDA approved the Obalon navigation system, that is, a portable console that dynamically tracks the balloon during placement using magnetic resonance and does not require X rays to confirm balloon positioning.…”

Section: Primary Bariatric Endoscopic Therapiesmentioning

confidence: 99%

A Comprehensive Review on Bariatric Endoscopy: Where We Are Now and Where We Are Going

et al. 2023

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Background: Obesity is a chronic disease that impairs quality of life and leads to several comorbidities. When conservative therapies fail, bariatric surgical options such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most effective therapies to induce persistent weight loss. Over the last two decades, bariatric endoscopy has become a valid alternative to surgery in specific settings. Primary bariatric endoscopic therapies: Restrictive gastric procedures, such as intragastric balloons (IGBs) and endoscopic gastroplasty, have been shown to be effective in inducing weight loss compared to diet modifications alone. Endoscopic gastroplasty is usually superior to IGBs in maintaining weight loss in the long-term period, whereas IGBs have an established role as a bridge-to-surgery approach in severely obese patients. IGBs in a minority of patients could be poorly tolerated and require early removal. More recently, novel endoscopic systems have been developed with the combined purpose of inducing weight loss and improving metabolic conditions. Duodenal mucosal resurfacing demonstrated efficacy in this field in its early trials: significant reduction from baseline of HbA1c values and a modest reduction of body weight were observed. Other endoscopic malabsorptive have been developed but need more evidence. For example, a pivotal trial on duodenojejunal bypasses was stopped due to the high rate of severe adverse events (hepatic abscesses). Optimization of these more recent malabsorptive endoscopic procedures could expand the plethora of bariatric patients that could be treated with the intention of improving their metabolic conditions. Revisional bariatric therapies: Weight regain may occur in up to one third of patients after bariatric surgery. Different endoscopic procedures are currently performed after both RYGB and SG in order to modulate post-surgical anatomy. The application of argon plasma coagulation associated with endoscopic full-thickness suturing systems (APC-TORe) and Re-EndoSleeve have shown to be the most effective endoscopic treatments after RYGB and SG, respectively. Both procedures are usually well tolerated and have a very low risk of stricture. However, APC-TORe may sometimes require more than one session to obtain adequate final results. The aim of this review is to explore all the currently available primary and revisional endoscopic bariatric therapies focusing on their efficacy and safety and their potential application in clinical practice.

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“…Endoscopic bariatric and metabolic therapies (EBMT) represent another progressive alternative that offers higher efficacy than pharmacotherapy and at the same time is less invasive and has a lower incidence of complications than classical surgical treatment. In some procedures, the cost of endoscopic treatments may be lower than those of bariatric surgery [ 106 ].…”

Section: Bariatric Surgerymentioning

confidence: 99%

Vitamin D and malabsorptive gastrointestinal conditions: A bidirectional relationship?

Giustina

Filippo

Allora

et al. 2023

Rev Endocr Metab Disord

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This paper is one of the outcomes of the 5th International Conference "Controversies in Vitamin D" held in Stresa, Italy from 15 to 18 September 2021 as part of a series of annual meetings which was started in 2017. The scope of these meetings is to discuss controversial issues about vitamin D. Publication of the outcomes of the meeting in international journals allows a wide sharing of the most recent data with the medical and academic community. Vitamin D and malabsorptive gastrointestinal conditions was one of the topics discussed at the meeting and focus of this paper. Participants to the meeting were invited to review available literature on selected issues related to vitamin D and gastrointestinal system and to present their topic to all participants with the aim to initiate a discussion on the main outcomes of which are reported in this document. The presentations were focused on the possible bidirectional relationship between vitamin D and gastrointestinal malabsorptive conditions such as celiac disease, inflammatory bowel diseases (IBDs) and bariatric surgery. In fact, on one hand the impact of these conditions on vitamin D status was examined and on the other hand the possible role of hypovitaminosis D on pathophysiology and clinical course of these conditions was also evaluated. All examined malabsorptive conditions severely impair vitamin D status. Since vitamin D has known positive effects on bone this in turn may contribute to negative skeletal outcomes including reduced bone mineral density, and increased risk of fracture which may be mitigated by vitamin D supplementation. Due to the immune and metabolic extra-skeletal effects there is the possibility that low levels of vitamin D may negatively impact on the underlying gastrointestinal conditions worsening its clinical course or counteracting the effect of treatment. Therefore, vitamin D status assessment and supplementation should be routinely considered in all patients affected by these conditions. This concept is strengthened by the existence of a possible bidirectional relationship through which poor vitamin D status may negatively impact on clinical course of underlying disease. Sufficient elements are available to estimate the desired threshold vitamin D level above which a favourable impact on the skeleton in these conditions may be obtained. On the other hand, ad hoc controlled clinical trials are needed to better define this threshold for obtaining a positive effect of vitamin D supplementation on occurrence and clinical course of malabsorptive gastrointestinal diseases.

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Endoscopic Treatment of Obesity and Nutritional Aspects of Bariatric Endoscopy

Cited by 12 publications

References 81 publications

Pancreatitis aguda asociada a balón intragástrico

Pancreatitis aguda asociada a balón intragástrico

A Comprehensive Review on Bariatric Endoscopy: Where We Are Now and Where We Are Going

Vitamin D and malabsorptive gastrointestinal conditions: A bidirectional relationship?

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