Spanish Intragastric Balloon Consensus Statement (SIBC): practical guidelines based on experience of over 20,000 cases.

Coll, Eduardo Espinet; García, Andrés J Del Pozo; Arau, Román Turró; Durán, Javier Nebreda; Rizo, Xavier Cortés; Jimenez, Athena; Usó, Miguel Ángel Escartí; Tornero, María Muñoz; Martínez, David Carral; López, Jaime Bernabéu; Bernal, Cristian Sierra; Martínez-Ares, David; Díez, Jesús Espinel; Valenciano, Carlos Marra-López; Vera, Javier Sola; Artero, Laura Sanchís; Jiménez, José Luís; Macián, Ramiro Carreño; Fernández, José María Díaz; Zulueta, Arnulfo Fernández; Alvarado, Claudia Consiglieri; Grecco, Eduardo; Silva, Lyz Bezerra; Neto, Manoel Galvão

doi:10.17235/reed.2022.9322/2022

Cited by 9 publications

(9 citation statements)

References 18 publications

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“…IGBs are the most versatile endoscopic procedure that does not alter gastric anatomy. This important feature allows its use both as a primary therapy in patients with mild obesity and also in overweight patients in order to improve metabolic complications [ 23 , 28 ]. Another application is the bridge-to-surgery implantation in severe and very-severe obesity patients in order to reduce intra and post-surgical complications [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is no evidence of superiority in the efficacy of a brand compared to another one. The general rule is that the higher BMI, the higher volumes and longer times of implantation are required [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The formers, such as persistent nausea, vomiting, generalized abdominal pain and/or discomfort, and reflux symptoms, are related to the space-occupying action in the gastric lumen and usually appear immediately after the insertion of the IGB and are self-limiting. However, the persistence of obstructive symptoms may require early IGB removal, which usually occurs in less than 5% of patients limiting their efficacy [ 23 ]. Serious AEs (SAE) include mucosal injury or perforation of the stomach or esophagus, gastrointestinal obstruction due to the migration of the balloon, gastric outflow obstruction, and infections due to bacterial overgrowth in the fluid filling the balloon [ 23 , 24 ].…”

Section: Primary Bariatric Endoscopic Therapiesmentioning

confidence: 99%

“…However, the persistence of obstructive symptoms may require early IGB removal, which usually occurs in less than 5% of patients limiting their efficacy [ 23 ]. Serious AEs (SAE) include mucosal injury or perforation of the stomach or esophagus, gastrointestinal obstruction due to the migration of the balloon, gastric outflow obstruction, and infections due to bacterial overgrowth in the fluid filling the balloon [ 23 , 24 ]. A meta-analysis by Trang et al conducted on a total of 938 patients who underwent the positioning of different types of IGBs, showed that nausea and vomiting were very frequent after an IGB positioning (63.3%; 95%CI 61.5–65.2% and 55.3%; 95%CI 53.6–57% respectively) whereas the account rate of SAEs was lower (5.2%; 95% CI 4.8–5.6%) [ 25 ].…”

Section: Primary Bariatric Endoscopic Therapiesmentioning

confidence: 99%

“…Regarding patients with a BMI of 25–30 kg/m 2 , a 6-month fluid-filled balloon is preferred, whereas in patients with BMI > 40 kg/m 2 , a 12-month fluid-filled balloon is preferred (consensus > 75%). For patients with a BMI of 30–40 kg/m 2 , which is the most common indication for IGBs implantation, there is a lower consensus to use a 12-month fluid-filled balloon [ 23 ].…”

Section: Primary Bariatric Endoscopic Therapiesmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%