Increased risk of postoperative pancreatic fistula in patients with chronic steroid usage undergoing pancreatectomy.

PURPOSE

Chronic steroid use may increase the risk of postoperative complications; however, its impact on postoperative outcomes after pancreatectomy has not been fully investigated. This study investigated the impact of chronic steroid use on surgical outcomes, particularly postoperative pancreatic fistulas (POPF).

METHODS

A retrospective analysis of 656 patients who underwent pancreatectomy between 2010 and 2021 was conducted. Patients who had been using steroids for ≥ 1 month at the time of surgery were classified into the steroid group. Postoperative outcomes were compared between the steroid-treated and non-steroid-treated groups.

RESULTS

Of the 656 patients, 17 (2.6%) were in the steroid group, which exhibited a significantly higher POPF rate than the non-steroid group (70.6% vs. 26.3%, p = 0.0002). A multivariate analysis identified chronic steroid use as an independent risk factor for POPF (odds ratio 4.718, 95% confidence interval 1.510-14.742; p = 0.0051). The results were confirmed using a propensity score matching analysis.

CONCLUSION

The risk of POPF was significantly increased after pancreatectomy in patients with chronic steroid use compared to those without chronic steroid use, and chronic steroid use was an independent factor significantly associated with POPF.