Objective To investigate the effect of abdominal dual tube drainage with continous irrigation in the treatment of pancreatic fistula after pancreatoduodenectomy. Methods The cases with postoperative pancreatic fistula after pancreaticoduodenectomy from both Department of Hepatobiliary Surgery, The PLA 101 Hospital and Department of Pancrea-tic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine from January to December 2017 were inclu-ded in this study. A total of 78 cases were divided into 2 groups, study (n=39) and control (n=39). The patients were trea-ted by abdominal dual tube drainage with continuous irrigation in study group and drainage with intermittent irrigation in control group. The other treatments were similar in two groups. Abdominal drainage with irrigation duration, the postoperative duration of hospital stay and rate of complication during drainage were compared between two groups. Results During abdominal drainage with irrigation, there were 8 cases found complication in control group including 2 cases of multiple organ failure improved after ICU treatment. Four cases with abdominal abscess were cured with puncture and drainage. Delayed abdominal hemorrhage was found in one case identified to be splenic artery rupture by digital subtraction angio-graphy and treated by embolization. Abdominal massive bleeding was seen one case in 2 groups respectively because of higher negative pressure of drainage and treated by urgent laparotomy. The rate of complication in study group was lower than in control group (P<0.05). The patients in study group had shorter duration of abdominal drainage with irrigation (26.0 days vs. 29.2 days) and shorter postoperative duration of hospital stay (29.0 days vs. 31.8 days) with significant statistical difference when compared with the patients in control group (P<0.01). Conclusions In the treatment of pancreatic fistula after pancreaticoduodenectomy, abdominal dual tube drainage with continuous irrigation may have lower complication rate due to lower negative pressure of drainage and reduce postoperative hospital stay.