Postpancreatectomy acute pancreatitis (PPAP) is a key factor increasing mortality after pancreatoduodenectomy.

• 24.3% of patients developed clinically relevant postoperative pancreatic fistula (CR-POP), with 90-day mortality at 9% in this group.
• PPAP is the strongest predictor of CR-POP (odds ratio 11.76) and 90-day mortality (odds ratio 4.88).

Understanding these links can help refine patient selection and risk assessment for better outcomes.

• Major morbidity occurred in 35.8% of patients, primarily linked to systemic inflammatory response syndrome and surgical complications.