Preoperative weight loss by intragastric balloon in super-obese patients treated with laparoscopic gastric banding: A case-control study

Background: The authors investigated the usefulness of preoperative treatment with the BIB intragastric balloon in super-obese patients before undergoing laparoscopic adjustable gastric banding (LAGB). Methods: The case-control study involved 43 case patients treated with the intragastric balloon followed by LAGB (Case group) and 43 sex-, age- and BMI-matched historical controls treated with LAGB alone. Results: Mean length of the intragastric balloon treatment was 164.4 +/- 39.7 days, with a fill volume of 609 +/- 95 ml. Total complication rate with balloon was 7.0% and percent excess weight loss (%EWL) was 26.1 +/- SD 9.3 %. At the time of gastric band placement, both operative time and hospital stay were shorter in patients treated previously with the balloon (Case group) than in the Control group patients. No Case patients required conversion to open surgery or had intraoperative complications. In the Control group, the rate of conversion was 16.3% (P<0.05) and the rate of intraoperative complications was 7.0%. Postoperative follow-up length was 1.1 +/- 1.0 years in Case patients and 4.4 +/- 1.8 years in Control patients (P<0.001). The %EWL produced by the intragastric balloon in the Case patients was identical to the %EWL observed in the first 6 months after LAGB in the Control group (26.1 +/- 9.3 vs 25.3 +/- 12.4%). %EWL 6 months after banding was higher in the Case patients than in Controls (33.6 +/- 12.5 vs 25.3 +/- 12.4%, P<0.01). However, no significant difference in %EWL between the two groups was observed at the subsequent postoperative evaluations. Conclusion: Preoperative treatment with the intragastric balloon reduced the risk of conversion to open surgery and the risk of intraoperative complications in super-obese patients treated with LAGB. Preoperative treatment with the intragastric balloon did not change the total weight loss after LAGB.