Post-pancreatectomy acute pancreatitis is crucial in predicting complications after pancreatoduodenectomy.

• 24.3% of patients developed clinically relevant postoperative pancreatic fistula (cr-popf); 90-day mortality was 3.4% overall, spiking to 9.0% with cr-popf.
• Post-pancreatectomy acute pancreatitis (ppap) was linked to a 4.88 times higher risk of 90-day mortality, making it a key independent predictor.

Surgeons can enhance patient selection and outcomes by integrating ppap into risk models for better postoperative management.

• Major morbidity occurred in 35.8% of patients, with ppap present in 10.8%, often due to preoperative cholangitis and other anatomical factors.