Hepatobiliary Surgery, Air Force General Hospital Typical case sharing Surgery: Liu Chengli May 2013 Patient: Male, 60 years old, married, Han nationality, birthplace: Hebei Province. He was admitted to the hospital for “epigastric distension with poor appetite for more than 1 month, aggravated for 10 days”. Brief history: the patient was admitted to the hospital with no obvious cause of epigastric distension, accompanied by poor appetite, hiccups, a feeling of fullness after eating, no nausea, vomiting, no abdominal pain, diarrhea, black blood stools, no fever, jaundice, no cough, cough sputum, poor results of gastric medication, symptoms worsened in the 10 days prior to admission to the hospital, and ultrasound was performed at the hospital to show that the middle-upper abdominal hypoechoic mass was 8.8*5.1 cm, and the abdominal cavity had multiple lymph node enlargement; Liu Chengli, Department of Liver and Gallbladder Surgery, Air Force General Hospital, saw a gastroscopy of the liver and gallbladder. Liu Chengli of Air Force General Hospital showed malignant tumor in duodenal bulb and descending part by gastroscopy; biopsy pathology: malignant tumor; after that, he went to several hospitals in Beijing, and the abdominal CT showed a huge mass in gastric sinus, pylorus and duodenal bulb, with a maximal cross-section of 7*6.1 cm, which conformed to duodenal carcinoma, invaded the head of the pancreas, pressed the portal vein and lower vena cava, and metastasized multiple lymph nodes around the portal hiatus and gastric sinus, and he was considered to have a large tumor, which had invaded neighboring organs. Considering that the tumor was large and invaded the neighboring organs, the tumor was not treated surgically in many hospitals. After admission to our hospital, he underwent abdominal enhanced CT and arteriovenous angiography, which showed that the tumor was huge and invaded the adjacent organs, and the surrounding blood vessels encircled the surface of the tumor, which made the surgery difficult. After adequate preoperative preparation, the patient underwent surgery and decided to perform pancreaticoduodenectomy according to his condition, and the tumor was successfully resected. The tumor was successfully removed. The patient was successfully discharged from the hospital after the operation and was followed up for 1 year without recurrence.