Association Between Preoperative GLP-1 Receptor Agonists Use and Perioperative Complications in Metabolic Bariatric Surgery: A Meta-Analysis.

OBJECTIVE

To evaluate the impact of preoperative GLP-1 receptor agonists (GLP-RAs) therapy on postoperative and intraoperative complications in patients undergoing metabolic bariatric surgery (MBS).

METHODS

A meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, Cochrane Library, Web of Science, and Scopus were searched from database inception to December 11, 2025. Eligible studies included observational cohorts reporting postoperative or intraoperative complications in patients receiving preoperative GLP-1 RAs therapy.

RESULTS

Eleven studies involving 14,631 participants were included. Preoperative GLP-1 RAs therapy did not significantly affect the overall risk of postoperative complications (OR = 1.07, 95% CI: 0.73–1.58, P = 0.720). Evidence regarding postoperative nausea and vomiting (PONV) was inconsistent across two studies. Two studies also reported a higher incidence of intraoperative tissue adhesions among patients receiving GLP-1 RAs therapy; however, these findings were summarized descriptively due to the limited number of available studies.

CONCLUSIONS

Preoperative GLP-1 RAs therapy does not appear to increase the overall risk of postoperative complications in patients undergoing MBS; however, moderate heterogeneity across studies suggests that the evidence remains inconclusive. Evidence regarding PONV remains inconsistent, while limited studies suggest a possible increase in intraoperative tissue adhesions. Further well-designed studies are required to clarify these potential associations.