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Peer-reviewedCC BYAnnals of gastroenterological surgery

Association Between Preoperative Steroid Use and Short-Term Outcomes Following Pancreaticoduodenectomy: A Nationwide Analysis Using the National Clinical Database.

  • Yoshito Tomimaru1
  • Hideki Endo2
  • Hiroyuki Yamamoto2,3
  • Teruhide Ishigame4,5
  • Hideki Ueno4,6
  • Ken Shirabe4,7
  • Hidetoshi Eguchi1
7 affiliations
  1. 1Department of Gastroenterological Surgery, Graduate School of Medicine The University of Osaka Suita Japan.
  2. 2Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo Japan.
  3. 3Department of Health Data Science Tohoku University Graduate School of Medicine Sendai Miyagi Japan.
  4. 4The Japanese Society of Gastroenterological Surgery Tokyo Japan.
  5. 5Department of Hepato-Biliary-Pancreatic and Transplant Surgery and Fukushima Medical University Fukushima, Fukushima Japan.
  6. 6Department of Surgery National Defense Medical College Tokorozawa Saitama Japan.
  7. 7Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Graduate School of Medicine Gunma University Maebashi Gunma Japan.
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Abstract

Background

Pancreaticoduodenectomy (PD) carries a high risk of postoperative complications. Although steroids are widely prescribed for various chronic diseases, the specific impact after PD remains unclear. This study evaluated the association between preoperative chronic steroid use and short-term outcomes following PD.Methods

This retrospective cohort study used Japanese National Clinical Database data from 2019 to 2022. Patients undergoing PD were categorized by preoperative chronic steroid use. To account for varying background factors, three multivariable regression models with different adjustment levels (Models 1-3) were constructed.Results

Of 40 878 patients, 521 (1.3%) had chronic steroid use prior to PD. The steroid group had higher crude rates of adverse outcomes, including postoperative pancreatic fistula (POPF; 30.7% vs. 22.1%) and severe complications (7.7% vs. 4.4%). In the most extensively adjusted multivariable model (Model 3), preoperative steroid use remained a significant factor associated with POPF (odds ratio [OR] 1.80, 95% confidence interval [CI] 1.47-2.20) and severe complications (OR 1.71, 95% CI: 1.22-2.40). The adverse impacts on infectious complications and surgery-related mortality were also consistently significant across all models, whereas preoperative steroid use was not significantly associated with re-operation in any of the models.Conclusions

Preoperative chronic steroid use is significantly associated with poor short-term outcomes after PD, including POPF, severe complications, infectious complications, and mortality. These risks remained consistent regardless of adjustment level, highlighting the need for intensive perioperative management.

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Cite

BibTeXRIS
BibTeX
@article{tomimaru2026association,
  title = {{Association Between Preoperative Steroid Use and Short-Term Outcomes Following Pancreaticoduodenectomy: A Nationwide Analysis Using the National Clinical Database.}},
  author = {Yoshito Tomimaru and Hideki Endo and Hiroyuki Yamamoto and Teruhide Ishigame and Hideki Ueno and Ken Shirabe and Hidetoshi Eguchi},
  journal = {Annals of gastroenterological surgery},
  year = {2026},
  month = oct,
  doi = {10.1002/ags3.70286},
  url = {https://europepmc.org/article/MED/42899166},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Association Between Preoperative Steroid Use and Short-Term Outcomes Following Pancreaticoduodenectomy: A Nationwide Analysis Using the National Clinical Database.
AU  - Yoshito Tomimaru
AU  - Hideki Endo
AU  - Hiroyuki Yamamoto
AU  - Teruhide Ishigame
AU  - Hideki Ueno
AU  - Ken Shirabe
AU  - Hidetoshi Eguchi
PY  - 2026
DA  - 2026/10/19
JO  - Annals of gastroenterological surgery
DO  - 10.1002/ags3.70286
UR  - https://europepmc.org/article/MED/42899166
AB  - Background  Pancreaticoduodenectomy (PD) carries a high risk of postoperative complications. Although steroids are widely prescribed for various chronic diseases, the specific impact after PD remains unclear. This study evaluated the association between preoperative chronic steroid use and short-term outcomes following PD.Methods  This retrospective cohort study used Japanese National Clinical Database data from 2019 to 2022. Patients undergoing PD were categorized by preoperative chronic steroid use. To account for varying background factors, three multivariable regression models with different adjustment levels (Models 1-3) were constructed.Results  Of 40 878 patients, 521 (1.3%) had chronic steroid use prior to PD. The steroid group had higher crude rates of adverse outcomes, including postoperative pancreatic fistula (POPF; 30.7% vs. 22.1%) and severe complications (7.7% vs. 4.4%). In the most extensively adjusted multivariable model (Model 3), preoperative steroid use remained a significant factor associated with POPF (odds ratio [OR] 1.80, 95% confidence interval [CI] 1.47-2.20) and severe complications (OR 1.71, 95% CI: 1.22-2.40). The adverse impacts on infectious complications and surgery-related mortality were also consistently significant across all models, whereas preoperative steroid use was not significantly associated with re-operation in any of the models.Conclusions  Preoperative chronic steroid use is significantly associated with poor short-term outcomes after PD, including POPF, severe complications, infectious complications, and mortality. These risks remained consistent regardless of adjustment level, highlighting the need for intensive perioperative management.
SN  - 2475-0328
ER  -