Background <p>Pancreaticoduodenectomy, also known as the Whipple procedure, is a complex surgery for which increased operative time is associated with worse outcomes for patients. Body composition has been shown to be a contributing factor to operative time and can vary widely amongst pancreaticoduodenectomy patients. We hypothesized that greater amounts of adipose tissue are associated with extended pancreaticoduodenectomy operative time.</p> Methods <p>Demographic variables were retrieved retrospectively from the medical record for the first 211 consecutive patients enrolled in an institutional biobanking protocol with malignancies associated with pancreatectomy. Our final cohort of 68 patients underwent a pancreaticoduodenectomy and had preoperative CTs available for body composition analysis. Variables of interest were associated with operating time.</p> Results <p>Younger patient age, greater number of lymph nodes removed, and the need for a vascular repair were all associated with increased operative time. When considering surgeries without vascular repairs (<i>n</i> = 56), neither subcutaneous adipose (<i>p</i> = 0.80) nor visceral adipose (<i>p</i> = 0.32) were associated with surgery length. Skeletal muscle was unique, with greater muscle mass tending to associate with longer operating times (<i>p</i> = 0.051). Additionally, a sexual dimorphism was revealed whereby increased operative time was associated with greater skeletal muscle mass for females (<i>p</i> = 0.005) but lower skeletal muscle mass for males (<i>p</i> &lt; 0.001).</p> Conclusions <p>Contrary to expectations, increased adiposity was not associated with extended pancreaticoduodenectomy operative time. However, skeletal muscle mass was associated with operative time in a sex-dependent matter. Assessment of skeletal muscle mass could prove useful in identifying patients at risk of prolonged pancreaticoduodenectomy operations.</p>