Pancreaticoduodenectomy is the main surgical procedure to treat tumors such as pancreatic head cancer, jugular cancer, lower bile duct cancer and duodenal cancer. This operation involves many organs such as pancreas, bile duct, stomach and intestine, which is a complex operation with many steps, and the incidence of postoperative complications and mortality rate is much higher than other abdominal surgeries. With the development of modern surgical techniques, the maturity of surgical methods and the advancement of surgical nutrition, the surgical mortality rate of pancreaticoduodenectomy has decreased, but the incidence of postoperative related complications is still as high as 30%-50%. The main complications include postoperative pancreatic leak, biliary leak, gastrointestinal anastomotic leak, abdominal bleeding, abdominal infection, delayed gastric emptying, intestinal obstruction, pulmonary infection, multiple organ dysfunction, etc., which are life-threatening in severe cases. Among them, postoperative pancreatic leakage is the most common, and the incidence of pancreatic leakage is reported to be 5%-25%. Postoperative pancreatic leakage can lead to a series of secondary complications, the most serious of which are abdominal bleeding and abdominal infection, which are the main causes of postoperative death. Huang Tao, Department of Hepatobiliary and Pancreatic Surgery, Henan Cancer Hospital The causes of pancreatic leakage are mainly the following: (1) disease and patient’s own factors, including patient’s age, degree and duration of jaundice, hypoproteinemia, whether there is chronic pancreatitis, pancreatic texture, pancreatic duct diameter, and combined diabetes, coronary heart disease, hypertension and other diseases. Most studies have shown a correlation between pancreatic texture and pancreatic leakage, with a high incidence of pancreatic leakage after surgery with a soft pancreatic texture. (2) Perioperative-related treatment factors, mainly including improvement of preoperative nutritional status, correction of anemia, postoperative intravenous nutrition and application of growth inhibitors. (3) Surgery-related factors, i.e., operating time, intraoperative bleeding, pancreatic stump and main pancreatic duct treatment, pancreatic stump anastomosis method, and operator’s operating technique level. In conclusion, on the basis of strengthening perioperative management, improving surgical operation skills and choosing safe and reliable pancreatic stump anastomosis methods are the main measures to prevent the occurrence of omission. The reconstruction of pancreatic stump and digestive tract is divided into pancreatic-jejunostomy and pancreatic-gastric anastomosis according to the available organs, and pancreatic-intestinal anastomosis is divided into end-to-end and end-to-side pancreatic-intestinal anastomosis. There are many types of pancreatic end-intestinal anastomosis in the process of development, and these are the main ones that have been used more often: pancreatic end-intestinal end-anastomosis with Peng’s bundle, pancreatic end-anastomosis with sleeve, non-mucosal pancreatic end-anastomosis, and pancreatic-enteropancreatic duct-mucosal end-anastomosis. There are also many types of pancreatic-intestinal end-lateral anastomosis, including: pancreatic-intestinal pancreatic duct-mucosal end-lateral anastomosis, the more commonly used sleeve-type pancreatic-intestinal end-lateral anastomosis, and the more recently used sleeve-type pancreatic-intestinal end-lateral layer anastomosis. With the improvement of anastomosis, pancreaticogastric anastomosis has also developed into many ways, mainly pancreaticogastric pancreatic duct-mucosal anastomosis, sleeve-type pancreaticogastric anastomosis and the increasingly used bundled pancreaticogastric anastomosis. A good pancreatic stump anastomosis has these characteristics: relatively easy anastomosis, low incidence of pancreatic leakage, and preservation of residual pancreatic exocrine function. Whether the pancreatic stump anastomosis is relatively simple and practical in terms of anastomosis operation affects the occurrence of pancreatic leakage. The search for safe and simple pancreatic stump anastomosis has been the focus of research by various surgical experts. The pancreaticogastric anastomosis has recently received increasing attention from surgeons because of the close proximity of the pancreas and stomach, the rich blood supply to the stomach wall, and the acidic environment that inhibits pancreatic enzyme activation. The double continuous locked-edge suture pancreatogastric anastomosis has the advantages of simple operation, safety and reliability compared with other anastomoses. Based on: (1) the pulpy muscle layer and mucosal layer of the posterior gastric wall are double-bound without adding any other sutures that damage the pancreas; (2) the mucosal layer is only longitudinally incised without removal, reducing the damage to the gastric wall; (3) the continuous locking-edge sutures of the mucosal layer are bound after being dragged into the gastric cavity, which is simple and convenient to operate; (4) the gastric stump that needs to be subsequently gastrointestinal anastomosed is utilized for intraluminal anastomosis, avoiding incision of the anterior gastric wall. (5) The use of locking edge suture can effectively prevent bleeding from the anastomosis of the posterior gastric wall; (6) The use of locking edge suture followed by binding avoids damage to the pancreatic parenchyma; (7) Biliopancreatic separation; (8) It is not affected by the size of the pancreatic stump. Double continuous locking edge suture pancreatogastric anastomosis surgical method: pancreaticoduodenectomy was performed according to the specifications for organ removal and lymph node dissection, and pancreatogastric anastomosis was performed according to the following methods after specimen removal. (1) Pancreatic stump treatment: the upper and lower edges of the pancreas were routinely sutured separately, and the sutures were retained as traction lines. The pancreas was severed, and the section was hemostatic by electrocoagulation, and if necessary, sutures were used for hemostasis with non-invasive sutures, and the pancreatic stump was freed for about 2 cm. The small vessels between the posterior part of the pancreas and the splenic vein were carefully ligated. A suitable silicone catheter (length 15 cm) was selected according to the diameter of the pancreatic duct and inserted as a support tube with a 5 cm insertion segment, and the support tube was fixed in the pancreatic section. ② Posterior gastric wall treatment: according to the location and size of the pancreatic dissection, the pulpy muscle layer of the posterior gastric wall was resected at an appropriate location in the posterior gastric wall, and the resection area was 2-3 cm in diameter, and the pulpy muscle layer of the posterior gastric wall was sutured with 3-0 Prolene sutures with continuous locking edges, and the mucosal layer below the pulpy muscle layer was incised in the longitudinal direction, and the length was less than 1 cm of the long diameter of the pulpy muscle layer resection, and the incised mucosal layer was sutured with continuous locking edges with 3-0 Prolene sutures suture. (3) Fixation of the pancreatic stump: send the mucosal layer locking edge suture into the stomach, pull the upper and lower marginal traction lines of the pancreas, gently pull the pancreatic stump into the gastric cavity, and tighten the posterior wall of the stomach against the free root of the pancreatic stump, keeping the pancreatic stump about 2 cm in the stomach. The sutures of the pulpy muscle layer were tightened outside the stomach and ligated at the root of the pancreatic stump, while the sutures of the mucosal layer were tightened inside the stomach and ligated to fix the pancreas. ④ Other GI tract reconstruction was performed in the same way as the conventional surgery. Indications for double continuous locked-edge suture pancreatogastric anastomosis: ①All benign and malignant tumors of the pancreatic head and chronic pancreatitis of pancreatic head mass type that require pancreaticoduodenectomy. For benign or low-grade malignant tumors in the neck of the pancreas, it is feasible to resect the middle part of the pancreas, close the proximal pancreatic section with sutures, and perform double continuous locking suture pancreatogastric anastomosis between the distal pancreas and the stomach.