Despite recent advances in the perioperative management of surgical patients and operative techniques, there is still a high incidence of postoperative complications (PCs) such as postoperative pancreatic fistula (POPF) after pancreatic surgery which can lead to life-threatening complications including intra-abdominal infections, severe sepsis, and massive bleeding. The most commonly used assessment tools for the prediction of PCs after gastrointestinal surgery are the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and estimation of physiologic ability and surgical stress (E-PASS). 1,2 POSSUM was developed in the United Kingdom in 1991 for surgical audit. 1 This scoring system is widely known as the first prevalent tool to predict PCs and has been used in various surgical subspecialties worldwide. On the other hand, E-PASS was developed in Japan