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Intragastric balloon as a novel modality for weight loss in patients with cirrhosis and morbid obesity awaiting liver transplantation

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Abstract

Introduction

In extreme obesity, bariatric surgery or weight loss by lifestyle modification is often not possible because of presence of decompensated cirrhosis. Endoscopic intragastric balloon placement may be used as minimal invasive technique to promote weight loss and make them better candidates for liver transplantation surgery; however, there is no literature in this regard.

Methods

Patients with body mass index (BMI) >40 kg/m2 or BMI between 35 and 40 (with a low graft to recipient weight ratio) were considered for weight reduction modalities including dietary counseling and intragastric balloon placement when feasible.

Results

Intragastric balloon placement was done in six males and two females, age 46 ± 5 years, BMI 43.5 ± 6.9 kg/m2. All patients (except one with hepatocellular carcinoma) had decompensated liver disease, mean Child score was 8.5 ± 1.6. Five of them had successful liver transplantation (three deceased and two living donor liver transplantation) after weight loss, while three are waiting. All these five patients had uneventful post-transplant course. All patients had transient vomiting except one, in whom volume of balloon was decreased due to persistent vomiting. All patients except one had weight loss. None of patients had any serious complications. Three of five patients maintained weight loss post-transplant also.

Conclusion

Intragastric balloon placement is a useful modality for promoting short-term weight loss and thereby making morbidly obese recipients fit for liver transplantation surgery.

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Authors and Affiliations

  1. Medanta Institute of Liver Transplantation, Medanta The Medicity, Gurgaon, 122 001, India

    Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Naveen Kumar, Rahul Rai, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Sumana K. Ramchandra, Vikram Raut & Arvinder Soin

  2. Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurgaon, 122 001, India

    Rajesh Puri & Randhir Sud

Authors
  1. Narendra Singh Choudhary
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  2. Rajesh Puri
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  3. Neeraj Saraf
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  4. Sanjiv Saigal
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  5. Naveen Kumar
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  6. Rahul Rai
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  7. Amit Rastogi
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  8. Sanjay Goja
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  9. Prashant Bhangui
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  10. Sumana K. Ramchandra
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  11. Vikram Raut
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  12. Randhir Sud
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  13. Arvinder Soin
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Corresponding author

Correspondence to Neeraj Saraf.

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Conflict of interest

NSC, RP, NS, SS, NK, RR, AR, SG, PB, SKR, UR, RS, and AS declare that they have no conflict of interest.

Ethics statement

The authors declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning Informed Consent as shown on Springer.com.

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Choudhary, N.S., Puri, R., Saraf, N. et al. Intragastric balloon as a novel modality for weight loss in patients with cirrhosis and morbid obesity awaiting liver transplantation. Indian J Gastroenterol 35, 113–116 (2016). https://doi.org/10.1007/s12664-016-0643-2

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  • DOI: https://doi.org/10.1007/s12664-016-0643-2

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