AB050. SOH26AB_0042. Pancreaticobiliary disease in glucagon-like peptide-1 receptor agonist users: a case series
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AB050. SOH26AB_0042. Pancreaticobiliary disease in glucagon-like peptide-1 receptor agonist users: a case series

Ruth Comerford1, Jean Coetser2, Osama Elfaedy2, Mark Behan2, Nikola Deletic2

1School of Medicine, University of Limerick, Limerick, Ireland; 2Department of Surgery, St. Luke’s General Hospital, Kilkenny, Ireland

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are novel drugs licensed for type two diabetes mellitus and weight loss. Concerns exist regarding their association with pancreaticobiliary complications, including acute pancreatitis, calculous cholecystitis, and cholelithiasis. We aim to explore the proposed association of GLP-1 RAs and pancreaticobiliary disease.

Methods: Prospective case series of eight patients presenting to the general surgery department at St. Luke’s General Hospital (SLGH) in a 10-month period with suspected GLP-1 RA-associated pancreaticobiliary disease. Analysis of GLP-1 RA duration of use, indication, and prior biliary pathology was carried out.

Results: Eight patients (seven female and one male) with current or prior GLP-RA use developed pancreaticobiliary complications (five calculous cholecystitis/cholelithiasis and three pancreatitis). Cholecystectomy was indicated in most patients. Duration of GLP-1 RA use varied (2–24 months). Acute pancreatitis occurred in patients both with and without gallstones, suggesting potential idiosyncratic reaction or GLP-1 RA-induced pancreatitis. No clear correlation between dose variations and interval of symptom onset/severity was seen in this series.

Conclusions: This series highlights the potentially under-recognised adverse effect of GLP-1 RAs in the form of pancreaticobiliary disease. Proposed theories include altered bile composition due to weight loss or impaired gallbladder emptying secondary to GLP-1 RA activity. Clinicians should vigilantly monitor abdominal symptoms in patients on GLP-1 RA therapy, particularly those undergoing rapid weight loss and those with pre-existing risk factors. Future work for this series could include a prospective case-control observational study to further analyse this proposed association.

Keywords: Calculous cholecystitis; glucagon-like peptide-1 receptor agonists (GLP-1 RAs); obesity; pancreatitis; type 2 diabetes mellitus

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab050
Cite this abstract as: Comerford R, Coetser J, Elfaedy O, Behan M, Deletic N. AB050. SOH26AB_0042. Pancreaticobiliary disease in glucagon-like peptide-1 receptor agonist users: a case series. Mesentery Peritoneum 2026;10:AB050.

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