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Latent pancreatic fistula was significantly associated with severe complications and worse outcomes after pancreatoduodenectomy. Early drain removal may be unfavorable for patients with some of these risk factors. Latent pancreatic fistula was significantly associated with severe complications and worse outcomes after pancreatoduodenectomy. Early drain removal may be unfavorable for patients with some of these risk factors.Nicotinamide adenine dinucleotide (NAD) is an abundant cofactor that plays crucial roles in several cellular proces