Abstract: Objective To investigate the correlation between the incidence of pancreatic fistula (POPF) after pancreaticoduodenectomy and the CT ratio of pancreatic to visceral fat and blood glucose.Methods 94 patients who underwent PD from January 2018 to December 2022 were selected.Postoperative blood glucose,pancreato-visceral fat CT ratio,blood biochemistry and other relevant indicators were collected to analyze the risk factors for POPF.Results Among the 94 patients,POPF grade B/C in 20 cases (21.3%); Logistic regression analysis showed that CT ratio of pancreas-visceral fat,preoperative lymphocyte/monocyte,and blood glucose on the first day after surgery were risk factors for postoperative pancreatic fistula in PD patients.Laparotomy is an independent risk factor for postoperative pancreatic fistula in PD patients.The sensitivity and specificity of pancreatic-visceral fat CT ratio to predict POPF were 0.80 and 0.58.The sensitivity and specificity of blood glucose prediction of POPF on the first day after surgery were 0.55 and 0.84，respectively.The sensitivity and specificity of POPF prediction were 0.60 and 0.78，respectively.Conclusion CT ratio of pancreatic to visceral fat combined with blood glucose on the first day after surgery may be a risk factor for predicting POPF in PD patients.

Key words: pancreatic fistula, blood glucose, CT ratio of pancreatic to visceral fat, pancreaticoduodenectomy