The aim of this study is to determine whether preoperative sarcopenia (low muscle strength/muscle mass) is correlated with time weighted average intraoperative hypotension in patients undergoing minimally invasive pylorus preserving pancreaticoduodenectomy.

Inclusion Criteria:

1. patients 20 years or older who undergo minimally invasive pylorus preserving pancreaticoduodenectomy

Exclusion Criteria:

1. emergency surgery
2. patients who cannot read consent forms(e.g., illiterate, foreigner, etc.)
3. patients with cognitive dysfunction
4. pregnant, lactating women
5. When hand grip test cannot be performed
6. patients with atrial fibrillation, moderate or severe valvular heart disease, left ventricular ejection fraction less than 35%

Patients undergoing minimally invasive pylorus preserving pancreaticoduodenectomy