Objective To study the relationship between the preoperative plain scan CT value of the pancreas and the risk of postoperative pancreatic fistula (PF).Methods The clinical and medical imaging data of 87 cases undergoing pancreaticoduodenectomy (PD) using duct-to-mucosa pancreaticojejunostomy in our hospital from 2010 to 2012 were reviewed retrospectively.The pancreatic CT value and the CT value ratios of pancreas/abdominal aorta was measured and compared between PF group and non-PF group.Results There were 17 PF cases in all 87 patients,the PF rate was 19.5％,Compared with non-PF group in whom the mean pancreatic CT value was (42.5 ± 3.7) HU,the plain scan pancreatic CT value in PF group(37.3 ±3.5) HU was significantly lower(P =0.000).Also,pancreatic CT value is correlatively lower in severe grade PF group patients than those in less severe grade PF group(r =0.832,P =0.000).Conclusions The preoperative plain scan pancreatic CT vaule can indirectly reflect the histological condition of pancreas and thus may become a useful index to evaluate the risk of postoperative pancreatic fistula after pancreaticoduodenectomy.It can also provide useful information to the surgeons while deciding pancreaticojejunostomy methods during the operation.