ObjectiveTo investigate predictive value of amylase level in intraperitoneal drainage fluid after pancreaticoduodenectomy (PD) for grade B and C pancreatic fistula (PF).MethodThe clinical data of 106 patients underwent PD in the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2018 were retrospectively analyzed.ResultsTwenty-four cases (22.6%) had the PF after the PD, in which of 18 cases of grade A, 4 cases of grade B, and 2 cases of grade C. The age, tumor diameter, pancreatic texture, and main pancreatic duct diameter were associated with the PF after the PD by the univariate analysis (P<0.050), the main pancreatic duct diameter (OR=4.856, P=0.004) was its independent risk factor. The amylase levels of intraperitoneal drainage fluid on day 5, 7, and 10 after the PD could better predict the occurrence of PF (AUC was 0.910, 0.951, 0.948, respectively), especially which on day 10 after the PD could better predict the occurrence of grade B and C PF (AUC was 0.938).ConclusionElevated amylase levels in peritoneal drainage fluid on day 5, 7, and 10 after PD have better diagnostic effects on PF, especially which on day 10 after PD has a better diagnostic effect on grade B and C PF.