Evidence map›Paper›PMID 41466140›Full record

ArticleSurgical endoscopy2026

Minimally invasive surgery reduces the risk of loss of independence after pancreatoduodenectomy in elderly patients.

Atsushi Nara, Hiroki Ueda, Yukue Shimizu, Daisuke Asano, Yoshiya Ishikawa, Keiichi Akahoshi, Eriko Katsuta, Junko Torigoe, Daisuke Ban

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Atsushi NaraDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
Hiroki UedaDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan. uedamsrg@tmd.ac.jp.
Yukue ShimizuDepartment of Clinical Nutrition, Institute of Science Tokyo Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Daisuke AsanoDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
Yoshiya IshikawaDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
Keiichi AkahoshiDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
Eriko KatsutaDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
Junko TorigoeDepartment of Clinical Nutrition, Institute of Science Tokyo Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Daisuke BanDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPancreatoduodenectomy (PD) is a highly invasive surgery that raises concerns about postoperative loss of independence (LOI), a critical outcome defined as a decline in activities of daily living (ADL). LOI reflects a significant shift in functional status, often requiring additional care such as rehabilitation or home-based healthcare. While reducing complications and mortality is prioritized, maintaining a preoperative lifestyle remains underexplored. Therefore, this study aimed to elucidate the risk factors of LOI after PD.

methodsWe retrospectively analyzed 215 patients underwent PD between August 2017 and April 2024. Patients were classified into young (< 65 years) and elderly groups (≥ 65 years). Using univariate and multivariate analyses, we assessed risk factors of LOI after PD.

resultsThere was no incidence of LOI in the young group, whereas 22 patients (16.7%) developed LOI in the elderly group. Univariate analysis revealed that age ≥ 80 years (P < 0.001), sarcopenia (P < 0.001), open surgery (P = 0.013), and malignant disease (P = 0.009) were the risk factors of LOI. Multivariate analysis identified age ≥ 80 years (P < 0.001), sarcopenia (P < 0.001), and open surgery (P = 0.040) as the independent risk factors of LOI in the elderly group. Using these three factors, we established LOI score. This LOI score significantly correlated with the incidence of LOI (P < 0.001).

conclusionsThis is the first study to identify the risk factors of LOI after PD. It may help the decision-making regarding MIS surgery with other risk factors in clinical practice.

Indexed as

Activities of Daily LivingPancreaticoduodenectomyPostoperative ComplicationsAdultAgedAged, 80 and overAge FactorsFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsSarcopeniaElderlyLoss of independenceMinimally invasive surgeryPancreatoduodenectomySarcopenia

Identifiers

PMID41466140
PMCPMC12971829

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.