S1212 Luminal Complications Attributed to Intra-Gastric Balloon Placement: A Systematic Review

Abstract

INTRODUCTION: Intra-gastric balloons (IGB) pose an effective, and generally well tolerated non-surgical modality for weight loss. Major complications from IGB placement are rare but could carry significant morbidity. In this comprehensive review, we aim to review the frequency of luminal complications of IGBs, outline the clinical features, and outcomes of these patients. METHODS: A comprehensive review of Ovid MEDLINE and EMBASE databases until April 7th, 2020 was conducted. Studies of any design were included if they reported on luminal complications following IGB placement including esophagitis, gastritis, ulcers, erosions, perforation, or luminal obstruction. Two independent reviewers selected and appraised studies using the Newcastle Ottawa Scale (NOS), Cochrane tool and the Murad tool. RESULTS: The most commonly encountered complication in population studies was gastritis, gastric erosions and gastric ulceration (1.4%) followed by esophagitis (0.93%). Gastric Outlet Obstruction (GOO), gastric perforation, bowel obstruction and esophageal perforation are rare complications with <1% prevalence each, however carry significant morbidity. A total of 75 patients developing luminal complications were identified in case reports/series. Of the complications encountered, gastric perforation appears to carry a high mortality (31.3%). CONCLUSION: Life-threatening complications of IGB placement are rare and hence IGBs remain safe devices for weight loss treatment. Frequently complications occured in the setting of operator inexperience, or patient non-compliance to balloon removal times and post-placement protocols. Being cognizant of these complications is necessary in implementing IGBs as adjunct weight loss modalities.Table 1