Pancreaticoduodenectomy is a major surgery, which is the highest level pursued by general surgeons and hepatobiliary surgeons. If general surgeons and hepatobiliary surgeons can do this surgery, basically other surgeries in general surgery will not be much difficult. First of all, we have to remove the head of the pancreas, which has more blood vessels, including the superior mesenteric artery, superior mesenteric vein, and many other blood vessels around it, as well as the portal vein and the upper 10-12 cm of the jejunum; we also have to remove the gallbladder and the lower part of the common bile duct, because the anatomical structure of the hepatoduodenal ligament and the common bile duct is more complicated, and there are more blood vessels. The gallbladder and the lower part of the common bile duct are also removed. After the removal of the six major organs: 1) pancreatic-intestinal anastomosis, which is prone to fistula; 2) biliary-intestinal anastomosis; and 3) gastrointestinal anastomosis. This surgery involves more organs to be removed, more anastomoses, longer surgery time, and surgery around blood vessels, making it a more difficult surgery and a major surgery.