Drainage fluid C-reactive protein levels can help predict clinically relevant pancreatic fistulas post-pancreaticoduodenectomy.

• 15.1% of patients developed clinically relevant pancreatic fistulas.
• CRP levels in drainage fluid on postoperative day 4 ≥6.5 mg/dl have an odds ratio of 4.95 for predicting fistulas, with a negative predictive value of 95.6%.

Consider using drain CRP measurements to enhance decision-making for patient management after surgery.

• Serum and drain CRP levels showed strong correlation, indicating that both can be valuable for postoperative assessments.