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Intragastric Balloon as Bridging Therapy Prior to Bariatric Surgery for Patients with Severe Obesity (BMI ≥ 50 kg/m2): a Systematic Review and Meta-analysis

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Abstract

Bariatric surgery for patients with severe obesity (body mass index (BMI) ≥ 50kg/m2) is technically challenging. Intragastric balloon (IGB) has been proposed for weight loss before bariatric surgery to reduce surgical risks but its efficacy remains unclear. We conducted a systematic review and meta-analysis of the effectiveness of IGB as bridging therapy and assess potential complications. Amongst 2419 citations, 13 studies were included. IGB resulted in a BMI reduction of 6.60 kg/m2 (MD=6.60, 95% CI: 5.06–8.15; I2=72%). The total post-procedural complication rate was 8.13% (95% CI: 4.04–13.17%), with majority being balloon intolerance. Overall, IGB is effective as a bridging therapy with adequate procedural safety profile, but further study is needed to evaluate the risk reduction for bariatric surgery and long-term weight-loss outcomes.

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Abbreviations

IGB:

intragastric balloon

BMI:

body mass index

EWL:

excess weight loss

RCT:

randomized controlled trial

MD:

mean difference

CI:

confidence interval

SD:

standard deviation

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Acknowledgements

We would like to thank Nay Lin Han for his assistance with the data analysis.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Jing Hong Loo, Yao Hui Lim & Hwee Ling Seah

  2. Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore

    Andrew Zhi Quan Chong & Kon Voi Tay

  3. Department of General Surgery, Woodlands Health Campus, Singapore, Singapore

    Kon Voi Tay

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  1. Jing Hong Loo
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Key points

• Intragastric balloon results in a substantial BMI reduction of 6.60 kg/m2 before bariatric surgery.

• The total post-procedural complication rate from intragastric balloon was 8.13%, with majority being balloon intolerance.

• Compared with other bridging therapies/no bridging, IGB achieved superior weight loss but its effect on post-bariatric surgery complications requires further study.

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Loo, J.H., Lim, Y.H., Seah, H.L. et al. Intragastric Balloon as Bridging Therapy Prior to Bariatric Surgery for Patients with Severe Obesity (BMI ≥ 50 kg/m2): a Systematic Review and Meta-analysis. OBES SURG 32, 489–502 (2022). https://doi.org/10.1007/s11695-021-05772-5

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