Abstract: OBJECTIVE To explore the changes and clinical value of serum C-reactive protein（CRP）/albumin（ALB）, ischemia modified albumin（IMA） and Ghrelin levels in abdominal infection after pancreaticoduodenectomy（PD）. METHODS A total of 130 PD patients admitted to our hospital were recruited and divided into the infection group（52 cases） and non-infection group（78 cases） according to whether abdominal infection occurred after surgery. The changes of serum CRP/ALB, IMA, and Ghrelin levels before and after surgery were detected and their clinical value were evaluated. RESULTS There were significant differences in the course of jaundice before operation, postoperative pancreatic fistula and abdominal effusion between the two groups（P＜0.05）. Serum CRP/ALB, IMA, Ghrelin levels and APACHEⅡ scores in the infection group were significantly higher than those in the non-infection group on 1, 3, and 5 days after surgery（P＜0.05）. Serum CRP/ALB（r=0.593, 0.500, 0.587）, IMA（r=0.684, 0.501, 0.638）, Ghrelin（r=0.504, 0.595, 0.585） and APACHEⅡ scores were positively correlated with APACHEⅡ scores in the infection group on the 1 st, 3 rd, and 5 th days after operation（P＜0.05）. Logistic regression analysis showed that serum CRP/ALB, IMA, and Ghrelin were significantly correlated with postoperative abdominal infections on the 1 st, 3 rd, and 5 th day after PD（P＜0.05）. The AUC of the combined diagnosis was 0.924, the diagnostic sensitivity was 82.69%, and the specificity was 88.46%, which was significantly better than the three separate diagnoses（P＜0.05）. CONCLUSION Serum CRP/ALB, IMA and Ghrelin significantly elevate in abdominal infection after PD, and are closely related to the occurrence of infection. Combined detection has good diagnostic value and can provide relevant evidence for clinical evaluation of the disease.