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. 2023;16(5):457-464.
doi: 10.1159/000531459. Epub 2023 Aug 14.

Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients

Gennaro Martines  1 , Agnese Dezi  1 , Carlo Giove  1 , Valerio Lantone  1 , Maria Tersa Rotelli  1 , Arcangelo Picciariello  1 , Giovanni Tomasicchio  1
Affiliations

Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients

Gennaro Martines et al. Obes Facts. 2023.

Abstract

Introduction: Bariatric surgery is a safe and effective treatment for obesity, although in super-obese patients (BMI ≥50 kg/m2) it can become challenging for anatomical and anesthesiologic issues. Several bridging therapies have been proposed to increase preoperative weight loss and decrease perioperative morbidity and mortality. The aim of this study was to compare the efficacy and safety of different two-stage approaches in super-obese patients: laparoscopic sleeve gastrectomy (LSG) following preoperative liraglutide therapy versus LSG with preoperative intragastric balloon (IGB) during a 1-year follow-up.

Methods: Clinical records of 86 patients affected by super-obesity who underwent two-stage approach between January 2019 and January 2022 were retrospectively reviewed using a prospectively maintained database. Patients were separated into two groups: those managed with preoperative IGB and those with liraglutide 3.0 mg prior to LSG. Weight (kg), BMI (kg/m2), %EWL, and %EBWL were reported and compared between the two groups at the end of bridging therapy, at 6th month and 12th month postoperatively. Postoperative complications were recorded.

Results: Forty-four patients underwent IGB insertion prior to LSG, while 42 were treated with liraglutide. There were no statistical differences in baseline weight and BMI. At the end of preoperative treatment, the group treated with IGB reported a significant reduction in BMI (47.24 kg/m2 vs. 53.6 kg/m2; p < 0.391) compared to liraglutide group. There were no differences recorded between the two groups concerning postoperative complications. At 6 months, the liraglutide group had lower %EWL (15.8 vs. 29.84; p < 0.05) and %EBWL (27.8 vs. 55.6; p < 0.05) when compared to IGB group. At 12 months, the IGB preserved with higher %EWL (39.9 vs. 25; p < 0.05) and %EBWL (71.2 vs. 42; p < 0.05).

Conclusion: A two-stage therapeutic approach with IGB prior to LSG in super-obese patients could be considered an attractive alternative to liraglutide as bridging therapy before bariatric surgery.

Keywords: Intragastric balloon; Liraglutide; Obesity; Sleeve gastrectomy; Weight loss.

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Conflict of interest statement

The authors have no conflicts of interests or disclosures to report.

Figures

Fig. 1.
Fig. 1.
Included patients’ flowchart. GLP-1, glucagon-like peptide-1; IGB, intragastric balloon; LSG, laparoscopy sleeve gastrectomy.
Fig. 2.
Fig. 2.
Relationship between intragastric balloon (IGB) (with blue) and liraglutide (Lira) (with red) management and body mass index (BMI), percent excess weight loss (%EWL), and percent excess body weight loss (%EBWL) at 6 and 12 months.
See this image and copyright information in PMC

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