Efectividad del balón gástrico y manga gástrica en adultos con obesidad: revisión sistemática

Abstract

Introduction: Obesity and its severe comorbidities significantly impair quality of life, driving the development of minimally invasive surgical interventions. Objectives: To evaluate the effectiveness of the intragastric balloon compared with laparoscopic sleeve gastrectomy in adults with obesity, by analyzing weight loss, metabolic changes, and complications. Methodology: A systematic review following the PRISMA 2020 guidelines was conducted. Eligibility criteria: Original studies involving adults undergoing these procedures, with a minimum follow-up of 6 months, published between 2021 and 2025. Information sources: A search was conducted in SCOPUS, PubMed/MEDLINE, SciELO, and Redalyc through February 2026. Quality assessment: Study quality was assessed using a structured 14-item tool and ROBINS-I to evaluate the risk of bias. Synthesis of results: A narrative qualitative synthesis was performed due to clinical and methodological heterogeneity. Results: Twenty studies were included to conduct this research. Sleeve gastrectomy achieved greater weight reduction (60–70% of excess weight at 12 months), high remission of type 2 diabetes (60–80%) and hypertension (60%). The intragastric balloon was a safe and reversible option, achieving 25–40% excess weight loss and a complication rate of <1%, although 50% of patients experienced weight regain after balloon removal. Discussion: Both interventions were effective. Their interpretation is limited by the variability in success criteria, heterogeneous designs, and controversy over long-term weight regain after intragastric balloon therapy. Conclusions: Sleeve gastrectomy offers greater weight loss and metabolic remission. The intragastric balloon is a safe non-surgical alternative. The technique should be selected individually. Keywords: intragastric balloon, bariatric surgery, laparoscopic sleeve gastrectomy, obesity, metabolic comorbidities