Outcomes of retained gastrointestinal debris during upper endoscopy

Gastrointestinal debris retention (GIDR) during endoscopy can result in aborted procedures, intubation, and aspiration. GIDR has increased significance with uptake of glucagon-like peptide-1 receptor agonist (GLP-1RA) use. Outcome analysis is vital to risk-stratify patients with GIDR during endoscopy. Our study evaluated the effect of GIDR on endoscopic complications.

This was a retrospective review of patients who underwent endoscopy between May 2016 and December 2021 with documented GIDR. The study included 138 patients with GIDR and 275 controls. Propensity score matching between patients with GIDR and controls was performed in a 1:2 ratio based on age, sex, body mass index (BMI), and American Society of Anesthesiologists (ASA) status. T-tests and chi square tests were used to compare continuous and categorical variables.

The GIDR group was younger and had lower BMI, with no difference in sex, race, American Society of Anesthesiologists status, or use of monitored anesthesia care. GIDR was more frequently encountered when indications were abnormal imaging, pain, and pancreatico-biliary. Amount of GIDR was quantified as "large" in 37.7% of cases and size of debris was associated with rate of aborted procedures.

Our study did not demonstrate a significant increase in post-procedure complications in patients with GIDR. Further, the GIDR group had higher rates of opiate use, which can guide stratification of retention risk.