Multivariate analysis identified the following independent risk factors for not achieving TO: age ≥ 80 [OR 15.949 (95% CI 1.641–154.956); p = 0.017], ASA II [OR 4.332 (95% CI 1.148–16.343); p = 0.030] and ASA III [OR 4.992 (95% CI 1.094–22.777); p = 0.038), and histopathological diagnosis other than pancreatic adenocarcinoma or cholangiocarcinoma [OR 3.167 (95% CI 1.084–9.256); p = 0.035] (Table 5). The gene discussed is ARSA; the disease is pancreatic adenocarcinoma.