Objective. The aim of the study was to evaluate possible risk factors of pancreatic fistula after distal pancreatic resections. Subjects and methods. We performed a retrospective single-centre clinical trial. 40 patients, underwent distal pancreatic resection were included. In order to evaluate possible risk factors we developed mathematical models, based on “Random forest” algorithm and studied “importance” values. Kendall correlations were also included in the analysis, p0,05. Results. According to “Random forest” model, based on 1st postoperative day data, the main risk factors of pancreatic fistula were tumor size, age and clinical stage, importance 53,2, 13,7, 12,5, roc auc 62%. Basing on 3-5 postoperative days data the main risk factors were amylase drain level, tumor size, stage and age, importance = 61,7, 11,5, 5,2, 5,2 (таб.1), roc auc=79%. The increase in blood amylase level at 2-3, 3-5 postoperative days significantly correlated with the increase in drain amylase level at 5-7 after surgery, r = 0,48, 0,76, p0,05. We detected significant correlation between the drain amylase level and leukocytes level at 3-5 days, r = 0,62, p0,05. Conclusion. The increase in blood amylase level may be considered as the main risk factor development of pancreatic fistula after distal pancreatic resections. The increase in drain amylase level is a potential risk factor of subsequent pancreatic fistula with clinically significant symptoms. The disease stage, tumor size and patient age may be also considered risk factor for pancreatic fistula.