To establish a nomogram model for predicting the risk in incisional hernia after pancreaticoduodenectomy (PD) to provide a basis for early intervention of incisional hernia.

The clinical data of 926 patients who underwent PD at Handan Central Hospital from January 2009 to January 2017 were retrospectively analyzed. 24 patients with incisional hernias (the incisional hernia group) were followed up, and 120 patients were randomly selected as having non-incisional hernia in a ratio of 1:5. Independent risk factors for postoperative incisional hernia were analyzed using univariate and logistic regression separately, and a relevant nomogram prediction model was established.

Age≥60 years old (OR=5.800, 95% CI 1.530~21.984), BMI≥24 kg/m² (OR=4.165, 95% CI 1.187~14.613), diabetes (OR=5.321, 95% CI 1.548~18.285), respiratory disease (OR=4.565, 95% CI 1.225~17.007), wound infection (OR=6.803, 95% CI 1.573~29.419) and operation time≥6 h (OR=6.934, 95% CI 1.938~24.813) is an independent risk factor for incisional hernia after PD (P<0.05). Based on the above six independent risk factors, a nomogram model was established and verified. The predicted value is basically the same as the measured value. The C-index index is as high as 0.890 (95% CI 0.854~0.926), which shows the nomogram model of this study has good accuracy and differentiation.

Age ≥60 years, BMI ≥24 kg/m², diabetes, respiratory disease, incision infection and operation time ≥6 h are independent risk factors for incisional hernia after PD. The nomogram prediction model established in this study has good accuracy and differentiation, which is conducive to the clinical screening of people at high risk of incisional hernia after PD and the development of targeted avoidance measures.