AI Article Synopsis
- The study examines the effects of intraoperative corticosteroids on postoperative complications in patients undergoing pancreatoduodenectomy (PD), finding no significant improvement in major complications or specific issues like pancreatic fistulas or infections.
- A meta-analysis of 5 studies involving 1,449 patients revealed no difference in outcomes between those who received corticosteroids and those who did not across various complications measured.
- The conclusion suggests that corticosteroids do not provide a protective advantage in this surgical context, emphasizing the need for further clinical trials to gather more robust evidence.
Article Abstract
Background: The intraoperative administration of corticosteroids has been shown to improve postoperative outcomes in patients undergoing surgery; however, the impact of corticosteroids on complications following pancreatoduodenectomy (PD) remains controversial.
Objective: This study aimed to evaluate the efficacy of perioperative corticosteroids on postoperative complications after PD.
Materials And Methods: A comprehensive search was conducted using the PubMed, Embase, and Web of Science databases for studies published prior to 1 July 2024. Of 7418 articles identified, a total of 5 studies were eligible for inclusion in this meta-analysis. The primary outcome was incidence of postoperative major complications (PMCs), while the additional outcomes were incidences of postoperative pancreatic fistulas (POPFs), infection, delayed gastric emptying (DGE), post-pancreatectomy hemorrhage (PPH), bile leakage, reoperation, and 30-day mortality. The study was registered in the PROSPERO database (CRD42024524936).
Results: Finally, 5 studies involving 1449 patients (537 with corticosteroids and 912 without corticosteroids) were analyzed. Intraoperative corticosteroids were not associated with any improvement in PMCs (p = 0.41). The incidence of POPF (p = 0.12), infectious complications (p = 0.15), or DGE (p = 0.81) were not significantly different between the two groups. No obvious differences were found in the incidence of PPH (p = 0.42), bile leakage (p = 0.68), 30-day mortality (p = 0.99), or reoperation (p = 0.26).
Conclusion: Perioperative corticosteroids did not significantly demonstrate any protective advantage in terms of postoperative complications after PD. This finding may serve as a reference for the perioperative use of corticosteroids in pancreatic surgery. Well-designed clinical trials are warranted in the near future in order to provide high-level evidence.
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| http://dx.doi.org/10.1245/s10434-024-16704-9 | DOI Listing |
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