Perioperative corticosteroids and pancreatic surgery outcomes: a systematic review and meta-analysis combining human expertise and AI support (ChatGPT)
- 1Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- 2Division of Surgery, Maggiore Della Carità University Hospital, Corso Mazzini 18, 28100 Novara, Italy
- 3Division of General Surgical Oncology, Robotic and HPB Surgery, SS. Antonio E Biagio E Cesare, Arrigo University Hospital, Alessandria, Italy
Abstract
Pancreatic surgery is associated with high postoperative morbidity. The role of corticosteroids (CCS) in pancreatic surgery remains uncertain. Systematic review and meta-analysis conducted in accordance with PRISMA guidelines. Eligible studies included patients undergoing pancreatic resection with perioperative CCS administration. Primary outcomes were mortality, morbidity and surgical site infections (SSI). Data extraction was cross-validated with artificial intelligence (ChatGPT). Nine studies (1913 patients), including five RCTs (554 patients), were included. CCS regimens consisted of hydrocortisone or dexamethasone, with or without postoperative continuation. The analysis showed no significant differences in mortality or major complications. Data from RCTs showed that CCS reduced SSI (OR 0.53, 95%CI 0.32–0.91, p = 0.02). Also, among patients undergoing pancreatoduodenectomy, CCS reduced morbidity (OR 0.61, 95%CI 0.39–0.98), SSI (OR 0.57, 95%CI 0.40–0.82), and shortened hospital stay (MD –1.57 days, p = 0.04). Agreement between manual and AI-assisted data extraction was high (r = 0.97–1.00), but substantial discrepancies were found. Perioperative CCS appear safe in pancreatic surgery and may reduce morbidity and SSI. Large multicentre RCTs are needed to define optimal regimens and identify patients most likely to benefit. AI-assisted review may complement traditional approaches but still require further refinement before they can be considered as reliable as human effort.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13304-026-02750-3.
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BibTeX
@article{martino2026perioperative,
title = {{Perioperative corticosteroids and pancreatic surgery outcomes: a systematic review and meta-analysis combining human expertise and AI support (ChatGPT)}},
author = {Marcello Di Martino and Andrea Saibanti and Gianluca Cassese and Mariantonietta Alagia and Fabrizio Panaro and Matteo Donadon},
journal = {Updates in Surgery},
year = {2026},
month = jul,
doi = {10.1007/s13304-026-02750-3},
url = {https://doi.org/10.1007/s13304-026-02750-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Perioperative corticosteroids and pancreatic surgery outcomes: a systematic review and meta-analysis combining human expertise and AI support (ChatGPT)
AU - Marcello Di Martino
AU - Andrea Saibanti
AU - Gianluca Cassese
AU - Mariantonietta Alagia
AU - Fabrizio Panaro
AU - Matteo Donadon
PY - 2026
DA - 2026/07/08
JO - Updates in Surgery
DO - 10.1007/s13304-026-02750-3
UR - https://doi.org/10.1007/s13304-026-02750-3
AB - Pancreatic surgery is associated with high postoperative morbidity. The role of corticosteroids (CCS) in pancreatic surgery remains uncertain. Systematic review and meta-analysis conducted in accordance with PRISMA guidelines. Eligible studies included patients undergoing pancreatic resection with perioperative CCS administration. Primary outcomes were mortality, morbidity and surgical site infections (SSI). Data extraction was cross-validated with artificial intelligence (ChatGPT). Nine studies (1913 patients), including five RCTs (554 patients), were included. CCS regimens consisted of hydrocortisone or dexamethasone, with or without postoperative continuation. The analysis showed no significant differences in mortality or major complications. Data from RCTs showed that CCS reduced SSI (OR 0.53, 95%CI 0.32–0.91, p = 0.02). Also, among patients undergoing pancreatoduodenectomy, CCS reduced morbidity (OR 0.61, 95%CI 0.39–0.98), SSI (OR 0.57, 95%CI 0.40–0.82), and shortened hospital stay (MD –1.57 days, p = 0.04). Agreement between manual and AI-assisted data extraction was high (r = 0.97–1.00), but substantial discrepancies were found. Perioperative CCS appear safe in pancreatic surgery and may reduce morbidity and SSI. Large multicentre RCTs are needed to define optimal regimens and identify patients most likely to benefit. AI-assisted review may complement traditional approaches but still require further refinement before they can be considered as reliable as human effort. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13304-026-02750-3.
SN - 2038-131X
SN - 2038-3312
ER -