Surgeons need to know that bile leaks and Klebsiella pneumoniae infections are major predictors of severe postpancreatectomy hemorrhage in patients with postoperative pancreatic fistulas.

• Postpancreatectomy hemorrhage occurred in 7.8% of patients, with grade b/c complications in 5.2%.
• The pancreaticojejunal anastomosis was the most frequent bleeding source (15.6%), followed by branches of the superior mesenteric artery (9.6%).

Understanding these predictors can enhance surgical decision-making and outcomes in high-risk patients.

• Cryptogenic hemorrhage made up 24.7% of grade b/c cases but was linked to lower mortality compared to other sources.