Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
Division of Gastroenterology, Department of Internal Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
Obes Surg. 2023 Sep;33(9):2718-2724. doi: 10.1007/s11695-023-06716-x. Epub 2023 Jul 15.
In Saudi Arabia, the prevalence of obesity has multiplied in the last decades leading to a surge in bariatric surgery and other endoscopic modalities. The intra-gastric balloon (IGB) is the most used endoscopic modality. Surgical management for IGB complications is required for gastrointestinal perforation and/or obstruction. However, the literature seems to underestimate these complications.
A retrospective descriptive study was conducted in King Fahd University Hospital, Saudi Arabia, from Jan 2017 to Dec 2021, including all patients with complicated IGB who necessitated any surgical procedure. Exclusion criteria were patients with complicated IGBs that were only managed conservatively or endoscopically.
A total of 326 patients were admitted with different complications after bariatric procedures. Of them, six patients were referred due to IGB complications that necessitated operative intervention. All patients were young females. Three patients had gastric wall perforation, and were managed by endoscopic removal of the IGBs followed by exploratory laparotomy. One patient had an intestinal obstruction on top of a migrated IGB that was surgically removed. One patient had failed endoscopic retrieval of IGB and required a laparoscopic gastrostomy. Another patient had an esophageal rupture that required left thoracotomy, pleural flap, and insertion of an esophageal stent. All cases were discharged and followed up with no related complications.
IGB is an endoscopic alternative, within specific indications, for the management of obesity. However, surgical management may be necessary to manage its complications, including gastrointestinal perforation, IGB migration, and failure of endoscopic removal.
在过去几十年中，沙特阿拉伯的肥胖患病率呈倍数增长，导致减重手术和其他内镜治疗方法的需求也随之增加。胃内球囊（IGB）是最常用的内镜治疗方法。对于 IGB 并发症，如胃肠道穿孔和/或梗阻，需要进行手术治疗。然而，文献似乎低估了这些并发症。
本研究是在沙特阿拉伯法赫德国王大学医院进行的一项回顾性描述性研究，时间为 2017 年 1 月至 2021 年 12 月，纳入所有因 IGB 并发症而需要任何手术治疗的患者。排除标准为仅接受保守或内镜治疗的 IGB 并发症患者。
共有 326 名患者因减重手术后出现不同的并发症而入院。其中，有 6 名患者因 IGB 并发症需要手术干预而被转诊。所有患者均为年轻女性。3 例患者发生胃壁穿孔，通过内镜取出 IGB 后行剖腹探查术治疗。1 例患者发生迁移性 IGB 合并肠梗阻，行手术切除。1 例患者因内镜取球囊失败而需要行腹腔镜胃造口术。另 1 例患者发生食管破裂，需要行左开胸术、胸膜瓣和食管支架置入术。所有患者均出院，随访期间无相关并发症。
IGB 是一种内镜治疗选择，适用于特定的肥胖症治疗适应证。然而，对于其并发症，包括胃肠道穿孔、IGB 迁移和内镜取出失败等，可能需要进行手术治疗。
