Impact of Intragastric Balloon Before Laparoscopic Gastric Bypass on Patients with Super Obesity: a Randomized Multicenter Study.

Abstract

Super obese patients are recommended to lose weight before bariatric surgery. The effect of intragastric balloon (IGB)-induced weight loss before laparoscopic gastric bypass (LGBP) has not been reported. The aim of this prospective randomized multicenter study was to compare the impact of preoperative 6-month IGB with standard medical care (SMC) in LGBP patients. Patients with BMI >45kg/m2 selected for LGBP were included and randomized to receive either SMC or IGB. After 6months (M6), the IGB was removed and LGBP was performed in both groups. Postoperative follow-up period was 6months (M12). The primary endpoint was the proportion of patients requiring ICU stay >24h; secondary criteria were weight changes, operative time, hospitalization stay, and perioperative complications. Only 115 patients were included (BMI 54.3±8.7kg/m2), of which 55 underwent IGB insertion. The proportion of patients who stayed in ICU >24h was similar in both groups (P=0.87). At M6, weight loss was significantly greater in the IGB group than in the SMC group (P<0.0001). Three severe complications occurred during IGB removal. Mean operative time for LGBP was similar in both groups (P=0.49). Five patients had 1 or more surgical complications, all in the IGB group (P=0.02). Both groups had similar hospitalization stay (P=0.59) and weight loss at M12 (P=0.31). IGB insertion before LGBP induced weight loss but did not improve the perioperative outcomes or affect postoperative weight loss.