Bio-enteric intragastric balloon in obese patients: a retrospective analysis of King Faisal Specialist Hospital experience.

BACKGROUND: Bio-enteric intragastric balloon (BIB) insertion is gaining popularity for weight reduction in obese patients. We evaluated the efficacy, tolerability, and safety of BIB in the treatment of obesity. METHODS: A total of 173 Saudi obese patients [mean+/-SD age 34.5 +/- 11.6 years, 58 (33.5%) were men] who underwent BIB (InaMed Corporation, California, USA) insertion were followed up clinically, biochemically, and endoscopically for 6-12 months. The mean+/-SD baseline body weight, excess weight, and body mass index (BMI) were 123.5 +/- 39.6 and 68.9 +/- 40.0 kg and 46.7 +/- 14.1 kg/m(2), respectively. Associated dietary control, exercise, and medical treatment were used in 67 (38.7%), 60 (34.7%), and 3 (1.7%), respectively. RESULTS: BIBs were safely and successfully inserted in 15.1 +/- 6.2 min, filled with 626.2 +/- 41.7 ml methylene blue solution, removed after a period of 189.7 +/- 68.3 days, within 14.1 +/- 6.3 min. BIB was not tolerated for 6 months in 33 (19.8%) patients. Body weight and BMI at 6 and 12 months postinsertion were significantly reduced to 112.5 +/- 35.7 kg and 43.1 +/- 13.1 kg/m(2), and 110.7 +/- 34.5 kg and 42.3 +/- 12.6 kg/m(2), respectively (p < 0.01 versus baseline by one-way ANOVA). Furthermore, the mean absolute weight loss and mean percentage excess weight reduction (EWR) at 6 and 12 months post-BIB insertion were 13.5 +/- 13.5 kg and 19.5 +/- 21.8, and 14 +/- 18.5 kg and 18.0 +/- 25.8, respectively. No mortality or major complications has occurred. EWR of >or=25% occurred in 24.1% and 30.1% of patients at 6 and 12 months postinsertion, respectively. CONCLUSION: BIB is a safe, simple, and potentially efficient procedure that is well-tolerated by the majority of patients.

Risk factors for biliary complications after living-donor liver transplant: a single-center experience.

OBJECTIVES: Biliary complications remain a major concern in living-donor liver transplant. They can lead to patient and graft loss. In this study, we retrospectively analyzed patients' records to identify factors that increase the frequency of biliary complications in living-donor liver transplant with an aim toward decreasing this frequency. MATERIALS AND METHODS: We performed 53 living-donor liver transplants between November 2002 and September 2007. Five cases were excluded because of graft or patient loss within 2 weeks resulting in 48 cases available for analysis. The effect of the following variables on the frequency of biliary complications was analyzed: recipient age, liver lobe used, number of graft bile ducts, number of biliary anastomoses, type of biliary anastomosis, and bile duct diameter 4 mm or smaller. RESULTS: Biliary complications were seen in 14 cases (29.1%). These included 9 biliary strictures, 3 bile leaks, and 2 bile leaks eventually healing as biliary strictures. The presence of more than 1 graft bile duct increased the frequency of biliary complications (P = .03). The other variables did not have a statistically significant effect on the frequency of biliary complications. CONCLUSIONS: The rate of complications in our experience is comparable to that already published. The presence of more than 1 bile duct in the graft is a risk factor for biliary complications in living-donor liver transplant. A review of the data suggests additional risk factors.