Abstract: Objective:To explore the risk factors of pancreatic fistula after pancreatoduodenectomy(PD) so as to provide the theoretical basis for preventing pancreatic fistula． Methods:Seventy-two patients were treated with standard PD surgical method，all reconstruction orders followed the Child act． The postoperative complications and age，gender，preoperative albumin level，preoperative bilirubin level，intraoperative blood transfusion，operative time，residual pancreatic texture，pancreatic duct diameter and preoperative diabetes of patients with pancreatic fistula were observed． The data were analyzed by univariate analysis and multivariate logistic analysis． Results:Postoperative complications occurred in 30 cases，the total occurrence rate of which was 41． 7%． The rate of mortality and occurrence rate of pancreatic fistula were 4． 2% and 11． 1%，respectively． Multivariate logistic regression analysis showed that the pliable texture residual pancreas and pancreatic duct diameter with less than 3 mm were the independent risk factors of pancreatic fistula(P 0． 01 and P 0． 05)． Conclusions:Small pancreatic duct diameter and pliable pancreatic texture predict the high occurrence of pancreatic fistula after PD．