['Postoperative pancreatic fistula (POPF) is a serious complication of pancreaticoduodenectomy (PD). Sarcopenia is a newly identified marker of frailty. We performed this study to assess whether preoperative sarcopenia has an impact on clinically relevant POPF formation.', 'A total of 266 consecutive patients who underwent a PD between 2010 and 2014 were enrolled in this retrospective study. Skeletal muscle mass was measured using preoperative computed tomography images. The impact of preoperative sarcopenia on clinically relevant POPF formation was analyzed using univariate and multivariate analyses.', 'Of the 266 patients, 132 (49.6\xa0%) were classified as having preoperative sarcopenia. The rate of clinically relevant POPF formation was significantly higher in the sarcopenia group (22.0 vs. 10.4\xa0%; P\u2009=\u20090.011). A multivariate logistic regression analysis showed that sarcopenia (odds ratio, 2.869; P\u2009=\u20090.007) was an independent risk factor for the development of clinically relevant POPF, along with a soft pancreas and a parenchymal thickness at the pancreatic resection site of ≥8\xa0mm.'] Does preoperative Sarcopenia Strongly influence the Risk of Postoperative Pancreatic Fistula Formation After Pancreaticoduodenectomy?