ALB and familial pancreatic carcinoma: In addition to immunonutrition, serum albumin and lymphocytes also play a role in tissue healing, collagen synthesis in the anastomosis, and inflammatory response.13,14 While there are studies showing the relationship between lower PNI values and negative postoperative results and poor prognosis in non-pancreatic cancers,12,15 studies about its negative effect on postoperative results of PD, especially including CR-POPF, are increasing recently.13,16 But as far as we know, this is the first study to present the PNI effect on the progression from BL to CR-POPF after PD.