Pancreaticoduodenectomy is one of the most complicated operations in abdominal surgery with wide resection range, great changes to the physiological structure of the patient, many intraoperative and postoperative complications, high surgical difficulty, In 1935, Whipple, an American surgeon, used it for the treatment of peri-potbelly tumor, so the operation is also called Whipple operation, and in 1937 Brunschwig used it for the treatment of Pancreatic head cancer, through the continuous efforts of surgeons, this procedure has become more and more standardized, and the complication rate and surgical mortality rate have been decreasing, and now it has become a classic procedure for treating lesions such as pancreatic head cancer and peri-pot belly cancer, but this procedure is mainly carried out in tertiary hospitals, and there are differences in surgical results. There are four main categories of diseases that require pancreaticoduodenectomy, but whether the surgery can be performed depends on whether the lesion is locally resectable and whether the patient’s systemic condition can withstand the surgical blow, and the final decision may be made based on the results of the exploration during surgery. 1.Tumors with high malignant degree mainly include pancreatic head cancer, lower bile duct cancer, duodenal papilla and peripapillary cancer, pot belly cancer, etc. 2.Low malignant tumors or benign lesions that cannot be locally resected such as endocrine tumors in the head of pancreas, intraductal tumors, cystic adenomas, pseudopapillary tumors, etc. 3. Occupational lesions in the head of pancreas that cannot be identified as benign or malignant, such as mass pancreatitis in the head of pancreas. 4.Complex trauma in the pancreatic head and duodenal region that cannot be repaired. The scope of surgical resection involves 6 organs and regional lymph nodes, and after the completion of resection, it is necessary to establish the continuity between the biliary tract and the gastrointestinal tract, the pancreas and the gastrointestinal tract and the gastrointestinal tract itself, and at least 3 anastomoses need to be made. There is no sufficient evidence that one procedure is clearly superior to the others. The specific areas of resection include: the entire gallbladder and common bile duct; the pylorus and the distal part of the stomach; the head of the pancreas; the entire duodenum; about 20 cm of the beginning of the small intestine; and the regional lymph nodes. What are the complications of pancreaticoduodenectomy In addition to the general surgical complications such as wound infection and abdominal bleeding, some special complications may occur in pancreaticoduodenectomy, and the incidence of complications varies from report to report. At present, the overall surgical mortality rate of this procedure has been reduced to less than 5%. The main postoperative complications are as follows: pancreaticenteric anastomotic fistula; biliary-enteric anastomotic fistula; gastrointestinal anastomotic fistula; gastrointestinal bleeding; delayed gastric emptying; postoperative pancreatitis; retrograde biliary tract infection. The pancreaticoduodenectomy is the only effective surgical treatment for pancreatic head cancer and peri-pot belly cancer, but due to the biological characteristics of pancreatic head cancer with high malignancy, even if the tumor is completely removed and the lymph nodes are cleared, there is still a high recurrence rate after surgery, with a 1-year survival rate of 10%-30% and a 5-year survival rate of <5%. The surgical effect of peri-pot belly cancer is significantly better than that of pancreatic head cancer. For low-grade malignant tumors or benign tumors in the head of pancreas, when local resection cannot be done due to anatomical factors or the requirement of radical treatment, pancreaticoduodenectomy can achieve very good results.