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Pancreatic fistula remains common, with limited ability to risk stratify patients preoperatively. The objective of this study was to identify risk factors for clinically‐relevant postoperative pancreatic fistula (CR‐POPF) that are routinely available in the preoperative setting.

Preoperatively available variables for all pancreaticoduodenectomies from 2014‐2017 were examined using a national clinical registry. The cohort was separated into risk factor identification and internal validation subgroups.

Among 15 033 pancreaticoduodenectomies, the CR‐POPF rate was 16.7%. CR‐POPF was more likely in patients that were male (odds ratio [OR], 1.51), obese (body mass index [BMI] > 30, OR, 1.97), had minimal preoperative weight loss (OR, 1.25), had a nondilated pancreatic duct (OR, 1.81), did not have diabetes, (OR, 1.80), did not receive neoadjuvant therapy (OR, 1.78), had no evidence of …