The Effect of Perioperative DEXamethasone on Postoperative Complications After PANcreaticoduodenectomy

This is a multicentric, prospective, randomized, double-blind, pragmatic, placebo-control study. Patients who are going to receive elective pancreaticoduodenectomy will be randomized to receive 0.2 mg/kg dexamethasone or saline placebo, administered as an intravenous bolus within 5 minutes after induction of anesthesia. The primary outcome is the Comprehensive Complication Index (CCI) score within 30 days after the operation, which will be compared between these two groups .

Inclusion criteria

• Adult patients ≥18 years of age;
• An indication for elective PD surgery;
• Patients understand the nature of this trial and are willing to comply;
• Patients are able to provide written informed consent;

Exclusion criteria

• Current or recent (within preceding 1 month) systemic use of glucocorticoids;
• Distant metastases including peritoneal carcinomatosis, liver metastases, distant lymph node metastases, and involvement of other organs;
• Patients may undergo left, central, or total pancreatectomy other than PD;
• Palliative surgery；
• Patients with high operative risk, as defined by the American Society of Anesthesiologists (ASA), with a score ≥ 4;
• Synchronous malignancy in other organs or second cancer requiring resection during the same procedure;
• Pregnant and lactating women.