ObjectiveTo investigate the factors that affect the occurrence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).MethodsThe clinical data of 114 patients underwent DP who were performed in the First Affiliated Hospital of Xinjiang Medical University from Jan. 2014 to Jun. 2019, were retrospectively analyzed.ResultsIn this group of 114 patients, 43 cases (37.7%) of POPF occurred after DP, including 19 cases of grade A (biochemical fistula), 21 cases of grade B, and 3 cases of grade C. The univariate analysis results showed that: BMI value, drinking history, preoperative plasma albumin level, postoperative plasma albumin level, postoperative neutrophil/lymphocyte ratio (NLR), preoperative and postoperative prognostic nutrition index (PNI) levels were significant different between the POPF group and non-POPF group (P<0.05). Multivariate analysis results showed that: preoperative plasma albumin>35 g/L [OR=0.115, 95%CI was (0.038, 0.348)], postoperative plasma albumin>35 g/L [OR=0.126, 95%CI was (0.031, 0.516)], and postoperative NLR value≤6.65 [OR=0.149, 95%CI was (0.048, 0.461)] were the influencing factors of POPF after DP. The area under curve of postoperative NLR was 0.731 [95%CI was (0.639, 0.824)]. ConclusionPreoperative and postoperative plasma albumin>35 g/L, as well as postoperative NLR ≤6.65 are protective factors for POPF after DP, and postoperative NLR can be used as a predictor of POPF.