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Background <p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) slow gastric emptying and may therefore increase the risk of retained gastric contents (RGC). The optimal duration of discontinuation before esophagogastroduodenoscopy (EGD) under sedation or general anesthesia remains controversial.</p> Methods <p>We conducted a single-center, retrospective, observational study of patients who underwent elective EGD between August 2023 and May 2025. According to GLP-1RA exposure, patients were classified as (i) no GLP-1RA use, (ii) GLP-1RA continued use, or (iii) GLP-1RA two-week hold. The primary outcome was the presence of RGC, defined as any solid residue or &gt; 100&#xa0;mL of fluid visualized during EGD. Multivariate logistic regression was used to explore the relationship between GLP-1RA use and RGC.</p> Results <p>RGC occurred in 0.4% (63/15902) of patients with no GLP-1RA use, 5.83% (6/103) of patients with GLP-1RA continued use, and 1.61% (1/62) of patients with GLP-1RA two-week hold. GLP-1RA continued use was associated with a tenfold higher RGC risk versus no GLP-1RA use (odds ratio [OR] 10.68, 95% CI 3.74–30.55; <i>p</i> &lt; 0.001), whereas a two-week hold reduced risk to a level statistically comparable with no GLP-1RA use (OR 2.99, 95% CI 0.37–23.89, <i>p</i> = 0.302). Obesity (BMI ≥ 28&#xa0;kg/m<sup>2</sup>) independently increased RGC risk and, even after a two-week hold, yielded a tenfold higher risk of RGC versus no GLP-1RA use. Additionally, concurrent colonoscopy exerted a strong protective effect of RGC, and no RGC events occurred in patients with GLP-1RA two-week hold and concurrent colonoscopy.</p> Conclusions <p>A two-week hold of GLP-1RA lowered RGC incidence to a low level comparable with no GLP-1RA use, especially in normal-weight or overweight patients and in those undergoing concurrent colonoscopy, but may be insufficient for obesity.</p>

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Effect of two-week perioperative glucagon-like peptide-1 receptor agonist interruption on retained gastric contents during esophagogastroduodenoscopy: a retrospective, observational study

  • 期刊论文

  • 发表日期：

    2026年7月9日

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  • Zhiyu Dong,
  • Ouyang Li,
  • Jiajun Wu,
  • Yanglei Li,
  • Zili Xiao,
  • Feng Li,
  • Tao Sun,
  • Jun Zhou,
  • Weidong Gu,
  • Danian Ji

摘要

Background

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) slow gastric emptying and may therefore increase the risk of retained gastric contents (RGC). The optimal duration of discontinuation before esophagogastroduodenoscopy (EGD) under sedation or general anesthesia remains controversial.

Methods

We conducted a single-center, retrospective, observational study of patients who underwent elective EGD between August 2023 and May 2025. According to GLP-1RA exposure, patients were classified as (i) no GLP-1RA use, (ii) GLP-1RA continued use, or (iii) GLP-1RA two-week hold. The primary outcome was the presence of RGC, defined as any solid residue or > 100 mL of fluid visualized during EGD. Multivariate logistic regression was used to explore the relationship between GLP-1RA use and RGC.

Results

RGC occurred in 0.4% (63/15902) of patients with no GLP-1RA use, 5.83% (6/103) of patients with GLP-1RA continued use, and 1.61% (1/62) of patients with GLP-1RA two-week hold. GLP-1RA continued use was associated with a tenfold higher RGC risk versus no GLP-1RA use (odds ratio [OR] 10.68, 95% CI 3.74–30.55; p < 0.001), whereas a two-week hold reduced risk to a level statistically comparable with no GLP-1RA use (OR 2.99, 95% CI 0.37–23.89, p = 0.302). Obesity (BMI ≥ 28 kg/m2) independently increased RGC risk and, even after a two-week hold, yielded a tenfold higher risk of RGC versus no GLP-1RA use. Additionally, concurrent colonoscopy exerted a strong protective effect of RGC, and no RGC events occurred in patients with GLP-1RA two-week hold and concurrent colonoscopy.

Conclusions

A two-week hold of GLP-1RA lowered RGC incidence to a low level comparable with no GLP-1RA use, especially in normal-weight or overweight patients and in those undergoing concurrent colonoscopy, but may be insufficient for obesity.