越來越多患者在手術前已在使用 GLP-1 藥物。最新醫學共識告訴你：大多數人不需要停藥——但有幾件事務必事先告知醫師。 More patients than ever are taking GLP-1 medications before surgery. The latest medical consensus: most patients don't need to stop — but there are important things to discuss with your surgical team.
Ozempic、Wegovy、Mounjaro……這些 GLP-1 受體促效劑（GLP-1RA）在近幾年已成為治療肥胖與糖尿病的重要武器。根據最新統計，每 8 位成年人中就有 1 位正在使用這類藥物——這意味著，不論你要接受的是什麼手術，外科醫師、麻醉醫師與整個手術團隊，都很可能遇到正在服用 GLP-1 藥物的患者。
Ozempic, Wegovy, Mounjaro — GLP-1 receptor agonist drugs (GLP-1RAs) have become major tools for treating obesity and diabetes. According to recent statistics, 1 in every 8 adults is currently taking one of these medications. This means surgical teams across all specialties — not just bariatric surgery — are routinely encountering GLP-1 users.
這帶來了一個全新的臨床課題：如果你正在打瘦瘦針、即將接受手術，你和你的醫療團隊應該注意哪些事？本文幫你整理最新醫學共識，給你清楚的答案。
This raises a new clinical challenge: if you're on a GLP-1 drug and facing surgery, what should you and your medical team be aware of? This article summarizes the latest medical consensus to give you clear answers.
本文整理自美國外科醫師學會（ACS）2026 年最新臨床討論及多篇研究，提供正在使用 GLP-1 藥物且面臨手術的患者作為參考。所有醫療決定，請與您的手術醫師及麻醉科醫師充分討論後再行定奪。
This article is based on the latest clinical discussions from the American College of Surgeons (ACS, 2026) and multiple research studies. It is intended as a reference for patients using GLP-1 medications who are facing surgery. All medical decisions should be thoroughly discussed with your surgeon and anesthesiologist.
外科醫師對使用 GLP-1 藥物患者最主要的疑慮，是胃內容物吸入（aspiration）的風險。
The primary concern among surgeons regarding GLP-1 users is the risk of gastric content aspiration during surgery.
GLP-1 藥物的機制之一，就是延緩胃排空——讓食物在胃裡停留更久，藉此抑制食慾。這讓醫療團隊擔心：即使患者已按照標準禁食時間空腹，胃裡可能仍有殘留食物，在麻醉時產生吸入性肺炎的危險。
One of GLP-1's mechanisms is slowing gastric emptying — keeping food in the stomach longer to suppress appetite. This raised concern that even after standard fasting, the stomach might still contain residual contents, potentially causing aspiration pneumonia during anesthesia.
最新資料顯示，持續使用 GLP-1 藥物的患者，並未出現吸入性肺炎風險升高的情形。相反地，中途停藥可能影響血糖穩定，對糖尿病患者尤其不利。
Current data show that patients continuously using GLP-1 medications do not experience elevated aspiration pneumonia risk. Stopping mid-course may destabilize blood sugar, which is particularly harmful for diabetic patients.
最重要的原則：務必在術前告知外科醫師及麻醉科醫師你正在使用的藥物名稱、劑量與頻率，讓醫師根據你的個別狀況評估是否需要調整。
The most important principle: always tell your surgeon and anesthesiologist the name, dose, and frequency of your GLP-1 medication before surgery, so they can assess whether any adjustment is needed for your specific situation.
除了避免風險，GLP-1 藥物還能幫助患者在手術前主動調整體重、準備更好的身體狀態。研究一再顯示，BMI 越高，手術相關風險越大——尤其 BMI 超過 50 的患者，併發症發生率有明顯的跳升。
Beyond avoiding risks, GLP-1 medications can help patients proactively lose weight and optimize their physical condition before surgery. Research consistently shows that higher BMI correlates with greater surgical risk — especially for patients with BMI above 50, where complication rates rise sharply.
對於 BMI 較高（60–70 以上）的患者，手術醫師可能會建議在手術前先降低 5–10% 體重，以降低麻醉與手術風險。GLP-1 藥物在這種情況下是非常有效的術前準備工具，可以幫助達成：
For patients with very high BMI (60–70+), surgeons may recommend losing 5–10% of body weight before surgery to reduce anesthetic and surgical risks. GLP-1 medications are highly effective preoperative preparation tools in this situation, helping to achieve:
穩定的血糖是術後良好癒合的基礎。
Stable blood sugar is the foundation of good postoperative healing.
腹部脂肪的減少讓外科醫師操作更容易、手術更安全。
Less abdominal fat makes the operation easier and safer for the surgeon.
體重減少後，呼吸道管理更容易，麻醉相關風險也降低。
After weight loss, airway management becomes easier and anesthesia-related risks decrease.
一項針對接受疝氣修補術前先使用 GLP-1 減重的研究（70 名患者）顯示，術後 30 天發病率僅 9.1%，低於一般平均水準。
A study of 70 patients who underwent hernia repair after GLP-1-assisted preoperative weight loss found a 30-day morbidity rate of only 9.1% — below typical rates for such procedures.
術前 GLP-1 減重的益處並不限於代謝手術。疝氣修補、器官移植評估、骨科手術（如人工關節置換）、消化道及食道手術等，都可能從術前降低 BMI 中受益。
The benefits of preoperative GLP-1 weight loss extend well beyond bariatric procedures. Hernia repair, transplant evaluations, orthopedic procedures (such as joint replacement), and gastrointestinal and esophageal surgeries can all benefit from preoperative BMI reduction.
GLP-1 藥物帶來的食慾抑制雖然有助減重，但長期可能導致熱量與營養素攝取不足，引發以下幾個值得注意的問題：
While GLP-1-induced appetite suppression aids weight loss, prolonged use can result in insufficient caloric and nutrient intake, creating several issues worth watching:
維生素 D 缺乏——影響免疫功能與骨骼健康，術後恢復更慢。
Vitamin D deficiency — impairs immune function and bone health, slowing postoperative recovery.
鐵質缺乏——可能引起貧血，增加手術中輸血需求及術後疲憊感。
Iron deficiency — may cause anemia, increasing transfusion needs and postoperative fatigue.
蛋白質攝取不足——影響傷口癒合與肌肉維持，術後恢復更困難。
Insufficient protein intake — impairs wound healing and muscle maintenance, making recovery harder.
肌肉流失（肌少症）——GLP-1 在幫助減去脂肪的同時，也可能加速肌肉流失，術後恢復期間尤其不利。
Muscle loss (sarcopenia) — GLP-1 medications can accelerate muscle loss alongside fat loss, which is particularly problematic during postoperative recovery.
目前醫界對 GLP-1 用藥者的營養監測標準尚未完全建立（不像減重手術後有完整的追蹤協議），因此更需要患者主動告知醫師，必要時接受營養師的個別評估，並定期監測相關血液指標。
Formal nutritional monitoring protocols for GLP-1 users have not yet been fully established (unlike the comprehensive protocols after bariatric surgery). This makes it even more important for patients to inform their doctor proactively, seek registered dietitian guidance when needed, and have relevant blood markers monitored regularly.
高雄長庚體重管理中心的團隊在術後營養監測方面擁有豐富經驗——這套專業同樣適用於 GLP-1 藥物使用者。如果你正在使用 GLP-1 藥物並計劃手術，歡迎向我們諮詢術前評估。
Our Weight Management Center team has extensive experience in postoperative nutritional monitoring — expertise that applies equally to GLP-1 medication users. If you're on a GLP-1 drug and planning surgery, we welcome you to consult us for a preoperative evaluation.
不少研究發現，GLP-1 藥物可能對術後傷口癒合有保護效果，這對許多患者而言是個好消息。
Multiple studies have found that GLP-1 medications may have a protective effect on postoperative wound healing — good news for many patients.
GLP-1 用藥者：4.1%
未用藥者：8.1%
感染率降低約 50%
GLP-1 users: 4.1%
Non-users: 8.1%
~50% reduction in infection rate
GLP-1 用藥者：3.8%
未用藥者：7.8%
另一研究：風險降低 29%
GLP-1 users: 3.8%
Non-users: 7.8%
Separate study: 29% risk reduction
糖尿病手術患者中，GLP-1 用藥者血腫風險降低逾 50%。
In diabetic surgical patients, GLP-1 users showed over 50% reduction in hematoma risk.
這些效果可能來自兩個方向：GLP-1 改善了血糖控制（特別有助於糖尿病患者的傷口癒合），同時也具有抗發炎特性，能降低術後局部的發炎反應，讓組織修復更順利。
These benefits likely come from two directions: GLP-1 improves blood sugar control (particularly helping diabetic patients' wound healing) and also has anti-inflammatory properties that reduce postoperative local inflammation, facilitating smoother tissue repair.
目前雖仍有部分研究未見到同樣的效果，但整體證據方向是一致的：GLP-1 藥物不會讓傷口狀況更差，多數研究反而顯示有所改善——這對正在使用這類藥物的患者而言，是個令人放心的結果。
While some studies have not found the same results, the overall direction of evidence is consistent: GLP-1 medications do not worsen wound outcomes, and most studies actually show improvement — a reassuring finding for patients on these medications.
如果你正在使用 GLP-1 藥物並計劃手術，以下幾個步驟非常重要：
If you are using a GLP-1 medication and planning surgery, the following steps are essential:
告知外科醫師、麻醉科醫師及所有參與術前評估的醫療人員，你正在使用的 GLP-1 藥物名稱、劑量與注射頻率（每日或每週）。
Tell your surgeon, anesthesiologist, and all medical personnel involved in preoperative assessment the name, dose, and frequency (daily or weekly) of your GLP-1 medication.
請醫師安排術前抽血，至少包含維生素 D、鐵蛋白（鐵質儲存指標）、白蛋白（蛋白質指標）與血色素（貧血篩檢）。
Ask your doctor to arrange preoperative blood tests including at minimum vitamin D, ferritin (iron stores), albumin (protein marker), and hemoglobin (anemia screen).
即使食慾受到抑制，也要優先確保蛋白質攝取充足（建議每日每公斤體重約 1–1.2 克）。可善用雞蛋、豆腐、雞胸肉、蛋白質補充品等高蛋白食物。
Even with suppressed appetite, prioritize adequate protein intake (roughly 1–1.2 g per kg body weight daily). Use high-protein foods such as eggs, tofu, chicken breast, and protein supplements.
GLP-1 藥物可能伴隨肌肉流失。術前進行適度的阻力訓練（如輕重量訓練、彈力帶運動），有助於保留肌肉量，改善術後恢復力。
GLP-1 medications may accompany muscle loss. Moderate resistance training before surgery (light weights, resistance bands) helps preserve muscle mass and improve postoperative resilience.
根據最新指引，大多數患者不需要術前停藥。是否需要調整，應由醫師根據你的整體狀況決定，請勿自行停藥。
According to the latest guidelines, most patients do not need to stop before surgery. Whether to adjust should be determined by your doctor — do not stop on your own.
根據 2024 年最新多學會聯合共識，大多數患者術前不需停藥。過去建議每週注射型停藥一週、每日型停藥一天，但新研究顯示停藥未必能有效清空胃內容物，且可能影響血糖控制。最重要的原則是：務必在術前如實告知手術及麻醉醫師你正在使用的藥物，由醫師根據個人狀況做最終判斷。
According to the 2024 multisociety consensus guidelines, most patients do not need to stop before surgery. Earlier guidance recommended stopping weekly injections one week before and daily injections one day before, but newer research shows stopping doesn't reliably empty the stomach and may impair glycemic control. The most important principle: always tell your surgical and anesthesia team what medication you're on, and let your doctor make the final call based on your individual situation.
GLP-1 藥物確實會延緩胃排空，這是早期疑慮的來源。然而，最新研究顯示持續使用 GLP-1 的患者，並未出現吸入性肺炎風險升高的情形。只要你如實告知麻醉醫師、遵循術前標準禁食指引，整體風險仍在可接受範圍內。部分特殊患者（如有嚴重胃食道逆流者）可能需要額外的術前評估，請與醫師充分溝通。
GLP-1 medications do slow gastric emptying, which was the basis for early concerns. However, the latest research shows that patients continuously using GLP-1 do not experience elevated aspiration pneumonia risk. As long as you inform your anesthesiologist and follow standard preoperative fasting guidelines, the overall risk remains acceptable. Some higher-risk patients (such as those with severe GERD) may need additional preoperative assessment — discuss this with your doctor.
是的，尤其對 BMI 較高（特別是超過 50）的患者，術前降低 5–10% 體重可以顯著減少手術的風險與難度。研究顯示，術前透過 GLP-1 減重的患者，疝氣修補術後 30 天發病率降至約 9%，低於一般水準。腹部脂肪的減少，也讓手術視野更清晰、操作更安全。
Yes, especially for patients with higher BMI (particularly above 50), losing 5–10% of body weight preoperatively can significantly reduce surgical risk and difficulty. Research shows that patients who lost weight with GLP-1 before hernia repair had a 30-day morbidity rate of approximately 9%, below the typical rate. Reduced abdominal fat also improves surgical visibility and safety.
GLP-1 藥物常見的營養缺乏問題包括：維生素 D、鐵質、蛋白質，並可能伴隨肌肉流失。建議術前進行血液檢查，依結果補充不足的營養素。日常飲食上，即使食量減少，也要優先確保蛋白質攝取充足（每日每公斤體重 1–1.2 克），可借助蛋白質補充品。需要個別化建議時，請尋求營養師的協助。
Common nutritional deficiencies with GLP-1 medications include vitamin D, iron, and protein, often accompanied by muscle loss. Preoperative blood tests are recommended, with supplementation based on results. Even with reduced intake, prioritize protein (1–1.2 g per kg body weight daily), using protein supplements as needed. For personalized guidance, consult a registered dietitian.
GLP-1 藥物和減重手術並非互相排斥，有時甚至可以搭配使用。一般而言，減重手術提供的長期減重效果更持久、對體組成的保護更完整（較能維持肌肉量）；而 GLP-1 藥物則適合暫時不想手術或條件尚未符合的患者。建議與我們的醫療團隊進行完整諮詢評估，找出最適合你個人需求的方案。
GLP-1 medications and bariatric surgery are not mutually exclusive — they can even be combined in some cases. Generally, bariatric surgery provides more durable long-term weight reduction and better body composition protection (better muscle mass preservation); while GLP-1 medications suit those who don't want surgery or don't yet qualify. We recommend a comprehensive consultation with our team to find the most personalized approach for you.
無論你正在使用 GLP-1 藥物考慮手術，或是評估減重手術的各種選項，高雄長庚體重管理中心的專業跨科別團隊都能提供個別化建議與完整術前評估。
Whether you're on GLP-1 medication and considering surgery, or evaluating your bariatric surgery options, the multidisciplinary expert team at CGMH Weight Management Center can provide personalized advice and comprehensive preoperative evaluation.
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