SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
This article is part of the Research TopicPerioperative Management and Clinical Challenges in Elderly Major Surgical PatientsView all 18 articles
Impact of frailty on outcomes of pancreatic surgery: A systematic review and meta-analysis
Provisionally accepted
- The First People's Hospital of Lin'an District, Hangzhou, China
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Objective: Frailty is being recognized as a risk factor for adverse outcomes after various surgical procedures. However, its impact on pancreatic surgery outcomes remains uncertain. We hereby reviewed evidence on the difference in the risk of complications and mortality between frail and non-frail patients undergoing pancreatic surgery. Methods: PubMed, Embase, Scopus, and Web of Science were searched from 1st January 1980 to 17th June 2025, for relevant studies. The endpoints of the study were all complications, Clavien-Dindo grade ≥3 (CD≥3) complications, reoperation, and readmissions. Random-effect meta-analysis was conducted. Results: 11 studies were included. A pooled analysis revealed that frailty was associated with an increased risk of all complications in patients undergoing pancreatic surgery (OR: 1.51, 95% CI: 1.01-2.24, I2 = 61%). Meta-analysis showed no significant difference between frail and non-frail patients for CD≥3 complications (OR: 1.34, 95% CI: 0.86, 2.09 I2=31%), readmission (OR: 1.41, 95% CI: 0.75, 2.62 I2=0%) and reoperation (OR: 2.32, 95% CI: 0.63, 8.50 I2=0%). However, frail patients had a significantly higher risk of short-term (OR: 2.54, 95% CI: 1.39, 4.61, I2=50%) mortality as compared to non-frail patients after pancreatic surgery. Sensitivity and subgroup analysis generated mixed results. Conclusions: The presence of preoperative frailty may lead to increased risk of short-term mortality and morbidity in patients undergoing pancreatic surgery. Frailty was not associated with major complications, readmission, or reoperations. However, results must be interpreted with caution owing to limited data and high inter-study heterogeneity.
Keywords: complications, Frail, geriatric, Mortality, Pancreatectomy
Received: 16 Sep 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Li, Gong, Chen and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mouchun Gong
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