Abstract：
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.
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.
摘要：
背景：在沙特阿拉伯，在过去的几十年中,肥胖症的患病率成倍增加,导致减重手术和其他内窥镜检查方法的激增.胃内球囊（IGB）是最常用的内窥镜检查方式。胃肠道穿孔和/或梗阻需要IGB并发症的外科治疗。然而,文献似乎低估了这些并发症.
方法：在法赫德国王大学医院进行了一项回顾性描述性研究，沙特阿拉伯,从2017年1月到2021年12月，包括所有需要任何外科手术的复杂IGB患者。排除标准是仅通过保守或内窥镜治疗的复杂IGB患者。
结果：共有326例患者在减肥手术后出现不同的并发症。其中,6例患者因需要手术干预的IGB并发症被转诊.所有患者均为年轻女性。3例胃壁穿孔,并通过内镜下切除IGB，然后进行剖腹探查术。一名患者在手术切除的迁移IGB顶部有肠梗阻。一名患者的IGB内窥镜检索失败，需要进行腹腔镜胃造口术。另一名患者的食管破裂需要进行左侧开胸手术，胸膜瓣,插入食管支架。所有病例均出院,随访无相关并发症发生。
结论：IGB是一种内镜替代方法，在特定的适应症中，用于肥胖的管理。然而,手术管理可能是必要的，以管理其并发症，包括胃肠穿孔,IGB迁移，和内窥镜切除失败。
方法：在法赫德国王大学医院进行了一项回顾性描述性研究，沙特阿拉伯,从2017年1月到2021年12月，包括所有需要任何外科手术的复杂IGB患者。排除标准是仅通过保守或内窥镜治疗的复杂IGB患者。
结果：共有326例患者在减肥手术后出现不同的并发症。其中,6例患者因需要手术干预的IGB并发症被转诊.所有患者均为年轻女性。3例胃壁穿孔,并通过内镜下切除IGB，然后进行剖腹探查术。一名患者在手术切除的迁移IGB顶部有肠梗阻。一名患者的IGB内窥镜检索失败，需要进行腹腔镜胃造口术。另一名患者的食管破裂需要进行左侧开胸手术，胸膜瓣,插入食管支架。所有病例均出院,随访无相关并发症发生。
结论：IGB是一种内镜替代方法，在特定的适应症中，用于肥胖的管理。然而,手术管理可能是必要的，以管理其并发症，包括胃肠穿孔,IGB迁移，和内窥镜切除失败。
