Intragastric Balloon as Bridging Therapy Prior to Bariatric Surgery for Patients with Severe Obesity (BMI ≥ 50 kg/m 2 ): a Systematic Review and Meta-analysis

Bariatric surgery for patients with severe obesity (body mass index (BMI) ≥ 50kg/m 2 ) is technically challenging. Intragastric balloon (IGB) has been proposed for weight loss before bariatric surgery to reduce surgical risks but its efficacy remains unclear. We conducted a systematic review and meta-analysis of the effectiveness of IGB as bridging therapy and assess potential complications. Amongst 2419 citations, 13 studies were included. IGB resulted in a BMI reduction of 6.60 kg/m 2 (MD=6.60, 95% CI: 5.06–8.15; I 2 =72%). The total post-procedural complication rate was 8.13% (95% CI: 4.04–13.17%), with majority being balloon intolerance. Overall, IGB is effective as a bridging therapy with adequate procedural safety profile, but further study is needed to evaluate the risk reduction for bariatric surgery and long-term weight-loss outcomes. Graphical abstract