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Weight regain after intragastric balloon for pre-surgical weight loss

World Journal of Gastrointestinal Surgery 2024年第7期16卷 2040-2046页

作者： Danielle Abbitt Kevin Choy Alexandra Kovar Teresa S Jones Krzysztof J Wikiel Edward L Jones Department of Surgery University of ColoradoAuroraCO 80045United States Department of Surgery Rocky Mountain Regional Veteran Affairs Medical CenterAuroraCO 80045United States

BACKGROUND Over one-third of Americans carry the diagnosis of obesity,many also with obesity-related *** can place patients at increased risk of operative and postoperative *** intragastric balloon has been shown to aid in minor weight loss,however its weight recidivism in patients requiring short interval weight loss has not been well *** To evaluate weight loss,ability to undergo successful elective surgery after intragastric balloon placement,and weight management after balloon *** This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective *** outcomes including weight loss,duration of balloon placement,successful elective surgery,weight regain postballoon and post-procedure complications were *** criteria included those with balloon in place at time of *** Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective *** patients were required to participate in a 12-month weight management program to be eligible for balloon *** surgeries included incisional hernia repair,umbilical hernia repair,inguinal hernia repair,and knee and hip *** average age at placement was 53 years±11 years,majority(91%)were *** average duration of intragastric balloon therapy was 186 days±41 *** average weight loss was 14.0 kg±7.4 kg and with an average percent excess body weight loss of 30.0%(7.9%-73.6%).Over half of the patients(52.0%)achieved the goal of 30-50 lbs(14-22 kg)weight ***-one patients(64%)underwent their intended elective surgery,2 patients(6%)deferred surgery due to symptom relief with weight loss ***-one of the patients(64%)have documented weights in 3 months after balloon removal,in these patients the majority(76%)gained weight after balloon *** pat

关键词： intragastric balloon Weight loss Obesity Bariatric Body mass index

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Effects of intragastric balloon placement in metabolic dysfunctionassociated fatty liver disease: A systematic review and metaanalysis

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World Journal of Hepatology 2021年第7期13卷 815-829页

作者： João Remíde Freitas Júnior Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Vitor Massaro Takamatsu Sagae Gabriel Mayo Vieira de Souza Guilherme Henrique Peixoto de Oliveira Sergio A Sánchez-Luna Thiago Ferreira de Souza Eduardo Turiani Hourneaux de Moura Cláudia Pinto Marques Souza de Oliveira Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP Departamento de GastroenterologiaFaculdade de MedicinaUniversidade de Sao PauloSao PauloSPBR Division of Gastroenterology and Hepatology Department of Internal MedicineBasil I.Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at BirminghamBirminghamAL 35294United States Department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil

BACKGROUND Metabolic dysfunction-associated fatty liver disease corresponds to a clinical entity that affects liver function triggered by the accumulation of fat in the liver and is linked with metabolic *** To evaluate the effects of the intragastric balloon(IGB)in patients with metabolic dysfunction-associated fatty liver disease through the assessment of liver enzymes,imaging and several metabolic *** A comprehensive search was done of multiple electronic databases(MEDLINE,EMBASE,LILACS,Cochrane and Google Scholar)and grey literature from their inception until February *** criteria involved patients with a body mass index>25 kg/m2 with evidence or previous diagnosis of hepatic *** analyzed before and after 6 mo of IGB removal were alanine aminotransferase(IU/L),gamma-glutamyltransferase(IU/L),glycated hemoglobin(%),triglycerides(mg/dL),systolic blood pressure(mmHg),homeostatic model assessment,abdominal circumference(cm),body mass index(kg/m2)and liver volume(cm3).RESULTS Ten retrospective cohort studies evaluating a total of 508 patients were *** 6 mo of IGB placement,this significantly reduced alanine aminotransferase[mean difference(MD):10.2,95%confidence interval(CI):8.12-12.3],gammaglutamyltransferase(MD:9.41,95%CI:6.94-11.88),glycated hemoglobin(MD:0.17%,95%CI:0.03-0.31),triglycerides(MD:38.58,95%CI:26.65-50.51),systolic pressure(MD:7.27,95%CI:4.79-9.76),homeostatic model assessment(MD:2.23%,95%CI:1.41-3.04),abdominal circumference(MD:12.12,95%CI:9.82-14.41)and body mass index(MD:5.07,95%CI:4.21-5.94).CONCLUSION IGB placement showed significant efficacy in improving alanine aminotransferase and gamma-glutamyltransferase levels in patients with metabolic dysfunctionassociated fatty liver disease as well as improving metabolic markers related to disease progression.

关键词： intragastric balloon Metabolic dysfunction-associated fatty liver disease Homeostatic model assessment Abdominal circumference Body mass index

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Effects on physiologic measures of appetite from intragastric balloon and endoscopic sleeve gastroplasty: results of a prospective study

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Chinese Medical Journal 2022年第10期135卷 1234-1241页

作者： Babusai Rapaka Daniel B.Maselli Gontrand Lopez-Nava Inmaculada Bautista-Castano Reem Matar Veeravich Jaruvongvanich Eric J.Vargas Andrew C.Storm Andres Acosta Barham K.Abu Dayyeh Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55905USA Madrid Sanchinarro University Hospital MadridSpain

Background: Endoscopic bariatric therapies can help address widening management gaps in obesity. Their ability to facilitate weight loss is largely tied to influences on appetite through perturbations of gastric emptying and accommodation. As these tools gain traction in obesity therapy, their physiologic underpinnings require exploration, which may enhance efficacy, tolerance, and patient-tailored ***: We prospectively assessed consecutive subjects with fluid-filled intragastric balloons (IGBs) (n = 18) placed between October 2016 and June 2017 or underwent endoscopic sleeve gastroplasty (ESG) (n = 23) from March 2018 to June 2018. Patients underwent physiologic appraisal at 3 months with13C-spirulina-based gastric emptying breath test to determine time to half emptying (T50), as well as maximum tolerated volume (MTV) of a standard nutrient drink test. Changes in T50 and MTV at 3 months were compared with percent total body weight loss (%TBWL) at 3 and 6 months using best-fit linear ***: The change in T50 at 3 months correlated with %TBWL at 3 months for IGB (P = 0.01) and ESG (P = 0.01) but with greater impact on %TBWL in IGB compared to ESG (R2 = 0.42vs. 0.26). Change in T50 at 3 months was predictive of weight loss at 6 months for IGB (P = 0.01) but not ESG (P = 0.11). ESG was associated with greater decrease in MTV compared to IGB (340.25 ± 297.97 mLvs. 183.00 ± 217.13 mL,P = 0.08), indicting an enhanced effect on satiation through decreased gastric accommodation. Changes in MTV at 3 months did not correlate with %TBWL for either IGB (P = 0.26) or ESG (P = 0.49) but trended toward significance for predicting %TBWL at 6 months for ESG (P = 0.06) but not IGB (P = 0.19).Conclusion: IGB and ESG both induce weight loss but likely through distinct gastric motor function phenotypes, and gastric emptying may predict future weight loss in patients with IGB.

关键词： intragastric balloon Endoscopic sleeve gastroplasty Gastric emptying Gastric accommodation Obesity

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Impact of intragastric balloon on blood pressure reduction:A retrospective study in Eastern North Carolina

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World Journal of Gastrointestinal Endoscopy 2021年第5期13卷 115-124页

作者： Gbeminiyi Olanrewaju Samuel Karissa Lambert Elijah Asagbra Glenn Harvin Eric Ibegbu Division of Gastroenterology East Carolina UniversityGreenvilleNC 27834United States Department of Internal Medicine Brody School of MedicineEast Carolina UniversityGreenvilleNC 27834United States Department of Health Services and Information Management East Carolina UniversityCollege of Allied Health SciencesGreenvilleNC 27834United States

BACKGROUND Obesity has evolved into a global *** prevalence of obesity and hypertension in eastern North Carolina are comparable,if not higher,than the national *** the United States,an estimated 34%of adults have hypertension,the most modifiable risk factor for heart disease and *** and pharmacological interventions often do not provide sustained weight loss in obese *** surgery offers an effective weight reduction with short-and long-term health improvements;however,a higher body mass index is associated with higher surgical morbidity and mortality,longer hospitalization,and increasing rates of 30-day readmission due to *** balloon may bridge a critical gap in the treatment of *** objective of this paper is to showcase the impact of endoscopic bariatric therapy on blood pressure *** To investigate the impact of intragastric balloon on blood pressure *** A retrospective chart review was conducted from January 1,2016 to January 31,2019 of consecutive adults who received intragastric balloon therapy(IGBT)in a gastroenterology private practice in Eastern North *** balloon was introduced into the stomach under endoscopic guidance,and while in the region of the gastric body,inflation with saline was performed at increments of 50 mL until target volume between 500 to 650 mL of saline was attained depending on the patient's gastric *** procedural complications were noted during endoscopic placement and removal of the balloon.A cohort study design was used for data analysis.A total of 172 patients had the Orbera^(■)intragastric balloon *** the 172 patients who had IGBT at baseline,11 patients(6.4%)requested early balloon removal due to foreign body sensation(n=1),and/or intolerable gastrointestinal adverse events(n=10).The reported gastrointestinal adverse events were nausea,vomiting,abdominal pain,and ***,6-mo follow-up data were ava

关键词： intragastric balloon Orbera^(■) Obesity Hypertension Systolic blood pressure Diastolic blood pressure

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Efficacy of intragastric balloons in the Markers of Metabolic Dysfunction-associated Fatty Liver Disease:Results from Meta-analyses

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Journal of Clinical and Translational Hepatology 2021年第3期9卷 353-363页

作者： Zi-Yuan Zou Jing Zeng Tian-Yi Ren Yi-Wen Shi Rui-Xu Yang Jian-Gao Fan Center for Fatty Liver Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghaiChina

Background and Aims:Nonalcoholic fatty liver disease,now renamed metabolic dysfunction-associated fatty liver disease(MAFLD),is common in obese *** balloon(IGB),an obesity management tool with low complication risk,might be used in MAFLD treatment but there is still unexplained heterogeneity in results across ***:We conducted a systematic search of 152 citations published up to September ***-analyses,stratified analyses,and meta-regression were performed to evaluate the efficacy of IGB on homeostasis model assessment of insulin resistance(HOMA-IR),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and gamma-glutamyl transpeptidase(GGT),and to identify patients most appropriate for IGB ***:Thirteen observational studies and one randomized controlled trial met the inclusion criteria(624 participants in total).In the overall estimate,IGB therapy significantly improved the serum markers change from baseline to follow-up[HOMA-IR:1.56,95%confidence interval(CI)=1.16–1.95;ALT:11.53 U/L,95%CI=7.10–15.96;AST:6.79 U/L,95%CI=1.69–11.90;GGT:10.54 U/L,95%CI=6.32–14.75].In the stratified analysis,there were trends among participants with advanced age having less change in HOMA-IR(1.07 vs.1.82).The improvement of insulin resistance and liver biochemistries with swallowable IGB therapy was no worse than that with endoscopic *** meta-regression analyses showed that greater HOMA-IR loss was predicted by younger age(p=0.0107).Furthermore,effectiveness on ALT and GGT was predicted by basal ALT(p=0.0004)and GGT(p=0.0026),***:IGB is effective among the serum markers of *** patients had a greater decrease of HOMA-IR after IGB therapy.

关键词： intragastric balloon Nonalcoholic fatty liver disease Insulin resistance Age groups Treatment outcome

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Six intragastric balloons:Which to choose?

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 238-259页

作者： George Stavrou Anne Shrewsbury Katerina Kotzampassi Department of Colorectal Surgery Addenbrooke’s HospitalCambridge CB22QQUnited Kingdom Department of Surgery Endoscopy UnitAristotle University of ThessalonikiThessaloniki 54636Greece

Endoscopically placed intragastric balloons(IGBs)have played a significant role in obesity treatment over the last 30 years,successfully bridging the gap between lifestyle modification/pharmacotherapy and bariatric *** they provide a continuous sensation of satiety that helps the ingestion of smaller portions of food,facilitating maintenance of a low-calorie diet,they have generally been considered an effective and reversible,less invasive,non-surgical procedure for weight ***,some studies indicate that balloons have limited sustainable effectiveness for the vast majority attempting such therapy,resulting in a return to the previous weight after balloon *** this review we try to summarize the pros and cons of various balloon types,to guide decision making for both the physician and the obese individual looking for effective *** analyzed the six most commonly used IGBs,namely the liquid-filled balloons Orbera,Spatz3,ReShape Duo and Elipse,and the gas-filled Heliosphere and Obalon-also including comments on the adjustable Spatz3,and the swallowable Obalon and Elipse-to optimize the choice for maximum efficacy and safety.

关键词： Obesity intragastric balloon Fluid-filled balloons Gas-filled balloons Swallowable balloons

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How to establish an endoscopic bariatric practice

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World Journal of Gastrointestinal Endoscopy 2024年第4期16卷 178-186页

作者： Daniel B Maselli Lauren L Donnangelo Brian Coan Christopher E McGowan Clinical Research True You Weight LossAtlantaGA 30342United States Clinical Research True You Weight LossCaryNC 27513United States

Obesity is a chronic,progressive,and relapsing disease of excess adiposity that contributes to more than two hundred medical conditions and is projected to affect more than half the adult population of the United States by the year *** the limited penetrance of traditional bariatric surgery,as well as the cost and adherence barriers to anti-obesity medications,there is growing interest in the rapidly evolving field of endoscopic bariatric therapies(EBTs).EBTs are minimally invasive,same-day,per-oral endoscopic procedures and include endoscopic sleeve gastroplasty,intragastric balloons,and endoscopic bariatric revisional *** field represents an exciting and innovative subspe-cialty within ***,building a successful endoscopic bariatric practice requires intentional,coordinated,and sustained efforts to overcome the numerous obstacles to *** barriers include acquisition of the technical and cognitive skillset,practice limitations including the availability of nutrition counseling,facility capabilities,direct-to-consumer marketing,and financial pressures such as facility and anesthesia *** the highest-volume center for metabolic and bariatric endoscopy in the United States,we provide insights into successfully establishing an endoscopic bariatric program.

关键词： Obesity Endoscopic bariatric therapies Bariatric endoscopy Endoscopic sleeve gastroplasty intragastric balloon Practice management

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