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Factors aggravating remnant pancreas atrophy following pancreatoduodenectomy and the effects of atrophy have not been extensively studied. This study aimed to evaluate the clinical factors affecting remnant pancreas atrophy and assess the effects of atrophy on quality of life, nutritional status, and pancreatic exocrine and endocrine functions. Data collected prospectively from 122 patients who completed 12months of follow-up, including computed tomography and the quality-of-life questionnaire, were analyzed. Pancreas volume was measured