Resumen de Spanish Intragastric Balloon Consensus Statement (SIBC): practical guidelines based on experience of over 20 000 cases
Eduardo Espinet Coll, Andrés J. del Pozo García, Román Turró Arau, Javier Nebreda Durán, Xavier Cortés, A. Serrano Jiménez, Miguel Ángel Escartí Usó, María Muñoz Tornero, David Carral Martínez, Jaime Bernabéu López, Cristian Sierra Bernal, Davíd Martínez Ares, Jesús Espinel Díez, Carlos Marra-Lopez Valenciano, Javier Sola Vera, Laura Sanchis Artero, José Luis Domínguez Jiménez, Ramiro Carreño, José Francisco Juanmartiñena Fernández, Arnulfo Fernández Zulueta, Claudia F. Consiglieri, Eduardo Grecco, Lyz Bezerra Silva, Manoel Galvão Neto
Background: intragastric balloons (IGBs) are a minimally invasive, increasingly popular option for obesity treatment. However, there is only one worldwide guideline standardizing the technical aspects of the procedure (BIBC, SOARD 2018). Objectives: to construct a practical guideline for IGB usage by reproducing and expanding the BIBC survey among the Spanish Bariatric Endoscopy Group (GETTEMO). Methods: a 140-question survey was submitted to all GETTEMO members. Twenty-one Spanish experienced endoscopists in IGBs answered back. Eight topics on patient selection, indications/contraindications, technique, multidisciplinary follow-up, results, safety, and financial/legal aspects were discussed. Consensus was defined as consensus ≥ 70 %. Results: overall data included 20 680 IGBs including 12 different models. Mean age was 42.0 years-old, 79.9 % were women, and the mean preoperative body mass index (BMI) was 34.05 kg/m². Indication in BMI > 25 kg/m², 10 absolute contraindications, and nutritional and medication measures at follow-up were settled. A mean %TBWL (total body weight loss) of 17.66 % ± 2.5 % was observed. Early removal rate due to intolerance was 3.62 %. Adverse event rate was 0.70 % and 6.37 % for major and minor complications with consensual management. A single case of mortality occurred. IGBs were placed in private health, prior contract, and with full and single payment at the beginning. Seven lawsuits (0.034 %) were received, all ran through civil proceeding, and with favorable final resolution. Conclusions: this consensus based on more than 20 000 cases represents practical recommendations to perform IGB procedures. This experience shows that the device leads to satisfactory weight loss with a low rate of adverse events. Most results are reproducible compared to those obtained by the BIBC.
