Chronic steroid use is not associated with increased short-term morbidity after distal pancreatectomy: A propensity-matched analysis.

BACKGROUND: A national study analyzing the association between chronic steroid use and outcomes after pancreatic resection is lacking. This study aimed to evaluate the association between chronic glucocorticoid use and outcomes after distal pancreatectomy using a national database. METHODS: A retrospective analysis of patients undergoing distal pancreatectomy was performed using the National Surgical Quality Improvement Program database (2018-2024). In addition, we used propensity score matching to compare patients on chronic steroids with those who were not. The outcomes measured included 30-day complications and mortality, need for readmission, prolonged hospital stay, and pancreatic fistula. RESULTS: Of the 6,876 patients who underwent distal pancreatectomy, 623 were on chronic steroids. After propensity score matching, 438 patients in the steroid group and 876 patients in the nonsteroid group were compared. There were no significant differences in pancreatic fistula (23.7% vs 21.7%; P = .3), major complications (31.7% vs 30.1%; P = .1), minor complications (42.2% vs 41.6%; P = .6), mortality (3.4% vs 3.2%; P = .6), readmission (15.8% vs 14.7%; P = .3), or prolonged length of stay (11.4% vs 10.5%; P = .5). On multivariate analysis, chronic steroid use was not independently associated with any adverse outcomes. CONCLUSION: Chronic glucocorticoid use was not associated with increased short-term morbidity, pancreatic fistula, or mortality following distal pancreatectomy. These findings suggest that chronic steroid dependence should not be considered a contraindication to distal pancreatectomy, although the results should be interpreted with caution, given the inability to assess dose-response relationships and the potential for residual confounding.