The application of several modified procedures in PD surgery The application of several modified procedures in PD surgery, 11 consecutive cases of pancreaticoduodenectomy in 8 months without complications. The modified procedures are: 1. pancreatic-intestinal anastomosis by —– purse-string pancreatic-intestinal monolayer sleeve anastomosis 2. bile-intestinal anastomosis by —– continuous bile duct jejunostomy or gallbladder jejunostomy 3. gastrointestinal anastomosis by —– modified B-2 style 4. preservation of the horizontal part of duodenum Other: clever placement of hepatic garden ligament, exact treatment of the pancreatic section.