Abdominal Morphologic Changes in MRI during Gastric Balloon Therapy

Abstract

Introduction: Adiposity and excessive weight are on the rise in western industrialized countries. In cases where conservative measures fail and surgical interventions are not (yet) desired, gastric balloon therapy has proven to be a safe and reversible endoscopic method. Methods: Aside from weight progression under gastric balloon therapy and by using MRI, our research paper describes the behavior of different abdominal body fat compartments at the beginning and at the end of the gastric balloon therapy. Additionally, the volume of the left liver lobe as well as the fill volume and performance of the gastric balloon were analyzed over the duration of treatment. For assessing potential impacts of weight reduction on the muscle mass, we determined the area of the m. psoas on a comparable cross-sectional area at the beginning and at the end of the therapy. Results: We were able to verify a significant reduction of the layer of subcutaneous fat, adipose capsule of kidney and intra-abdominal fatty tissue during the therapy. The volume of the left liver lobe was shrinking in addition to a muscle loss during the balloon therapy. The volume of the gastric balloon remained stable (not hyperinflation). There were variable gas bubbles in the gastric balloon. Conclusion: The gastric balloon is a temporary and successful option for weight reduction by reducing body fat, liver volume but also muscle mass.

Meta‐analysis: Impact of intragastric balloon therapy on NAFLD‐related parameters in patients with obesity

“…Eighteen studies ( n = 888, I 2 = 0%) 7,41–44,46–49,51–59 evaluated the effect of IGB therapy on BMI. These studies showed a significant reduction, MD: −4.83 [95% CI: −4.31 to −5.36, p < 0.01] (Figure 10A).…”

“…41,42 Zerrweck et al 44 compared gastric bypass with pre-operative IGB treatment to gastric bypass alone. The remaining 14 studies were non-comparative observational studies, [46][47][48][49][50][51][52][53][54][55][56][57][58][59] as shown in Tables 3 and 4.…”

“…Four studies (n = 59, I 2 = 90%) 42,46,50,59 evaluated the impact of IGB on liver volume by using Imaging. These studies showed a non-significant reduction in liver volume, MD: −397.90 [95% CI: −212.78 to −1008.58, p = 0.20] as seen in Figure 6.…”

Magenballonimplantation – eine Bestandsaufnahme unter Berücksichtigung eigener Erfahrungen

“…Wir haben in einer eigenen Studie die Therapie mittels Magenballon (BIB™ System Intragastric Ballon, apollo endosurgery, Austin, Texas, USA) in Bezug auf die Veränderungen der abdominellen Fettkompartimente, der Muskelmasse anhand eines Markermuskels, und das Volumen der linken Leber mittels MRT untersucht (n = 12) [ 26 ] . In diesen ausgewählten Fällen wurde die Magenballonimplantation als reversible Therapie im Rahmen eines Mehrstufenkonzepts angeboten oder war ausdrücklich gewünscht worden.…”

“…stärkster epigastrischer Schmerzen, die jeweils medikamentös/ konservativ nicht kontrollierbar waren, sowie 1x Verlust des Ballons via naturalis). Allerdings ist unsere Studiengruppe im Vergleich sehr klein [ 26 ] . Stavrou et al diskutierten untersucherbezogene technische Probleme bei der Anwendung des Magenballons als Ursächlich für viele Komplikationen dieser Therapieform [ 40 ] .…”