Background: In a pathological examination of pancreaticoduodenectomy for pancreatic head adenocarcinoma, resection margins have no cancer cells within 1 mm, the resection is considered as R0 resection; resection margins have cancer cells within 1 mm, the resection is recognized as R1 resection. The pathological examinations of the resection margins are complicated and depend on the subjective experiences of physicians to some extent. This study aims to design a computer-aided diagnosis (CAD) system based on texture features of preoperative computer tomography (CT) images to evaluate a resection margin was R0 or R1.Methods: This study retrospectively analyzed 86 patients who were diagnosed as pancreatic head adenocarcinoma by preoperative abdominal CT examination. These patients underwent pancreaticoduodenectomies, then their resection margins were pathologically diagnosed as R0 or R1. The CAD system consists of five stages: (i) delineate and segment regions of interest (ROIs); (ii) by solving discrete Laplacian equations with Dirichlet boundary conditions, fit ROIs to rectangular regions; (iii) enhance textures of ROIs combining wavelet transform and fractional differential; (iv) extract texture features combining wavelet transform and statistical analysis methods; (v) reduce features using principal component analysis (PCA) and perform classification using support vector machine (SVM), use a linear kernel function and leave-one-out cross-training and testing to reduce overfitting. Mann-Whitney U-test is used to explore associations between texture features and histopathological characteristics.Results: The developed CAD system achieved an AUC (area under receiver operating characteristic curve) of 0.8614 and an accuracy of 84.88%. Setting p-value ≤ 0.01 in the Mann-Whitney U-test, two features of run-length matrix, which derived from diagonal subbands in wavelet decomposition, showed statistically significant differences between R0 and R1.Conclusions: It indicates that the developed CAD system is rewarding for discriminating R0 from R1. Texture features can potentially enhance physicians' diagnostic ability.