Scholarlink

Background <p>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.</p> Objective <p>This study aimed to evaluate the efficacy of perioperative corticosteroids on postoperative complications after PD.</p> Materials and Methods <p>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).</p> Results <p>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 (<i>p</i>&#xa0;=&#xa0;0.41). The incidence of POPF (<i>p</i>&#xa0;=&#xa0;0.12), infectious complications (<i>p</i>&#xa0;=&#xa0;0.15), or DGE (<i>p</i>&#xa0;=&#xa0;0.81) were not significantly different between the two groups. No obvious differences were found in the incidence of PPH (<i>p</i>&#xa0;=&#xa0;0.42), bile leakage (<i>p</i>&#xa0;=&#xa0;0.68), 30-day mortality (<i>p</i>&#xa0;=&#xa0;0.99), or reoperation (<i>p</i>&#xa0;=&#xa0;0.26).</p> Conclusion <p>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.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The Effects of Perioperative Corticosteroids on Postoperative Complications After Pancreatoduodenectomy: A Debated Topic of Systematic Review and Meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年1月2日

查看全文
  • Haonan Liu,
  • Kongyuan Wei,
  • Ruiqi Cao,
  • Jiaoxing Wu,
  • Zhengyuan Feng,
  • Fangzhou Wang,
  • Cancan Zhou,
  • Shuai Wu,
  • Liang Han,
  • Zheng Wang,
  • Qingyong Ma,
  • Zheng Wu

摘要

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.