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

Abstract

Pancreatoduodenectomy (PD) is a complex surgery with high morbidity and mortality, often associated with complications like post-pancreatectomy hemorrhage (PPH) and postoperative pancreatic fistulas (POPF). The corticosteroids administered intraoperatively has been shown to improve postoperative outcomes in patients undergoing surgery. However, their impact on complications following PD remains controversial. A comprehensive review of literature found no significant impact of perioperative corticosteroids on postoperative complications in PD, including postoperative major complications (PMCs), POPF, infectious complications, delayed gastric emptying (DGE), post-pancreatectomy hemorrhage (PPH), bile leakage, reoperation, or 30-days mortality. Other medications, such as octreotide, antibiotics, and probiotics, have shown potential in reducing complications, but further research is needed, especially for corticosteroids in PD. In the near future, more randomized controlled trials should be conducted, along with well-designed clinical studies, to provide high-level evidence for the potential benefits of corticosteroids in PD for targeted populations.