中文摘要：

自1935年Whipple报道胰十二指肠切除术以来，该手术目前仍然是腹部外科领域最复杂的手术。近年来，随着手术技术的提高和影像学、麻醉、重症监护的发展，胰十二指肠切除术死亡率〈5％，但手术并发症发生率仍高达30％～40％。本文着重讨论胰十二指肠切除术围手术期及术中存在的陷阱以及相应的对策。

英文摘要：

Pancreaticoduodenectomy （PD） is the pro- cedure for treating adenocarcinoma in periampullary region. This involves resection of multiple organs and complex reconstruc- tions. The modern surgery has witnessed the dramatic improve- ment in outcomes after PD. Mortality has dropped to less than 4%, however, the complication rate remains high, making this procedure still a big challenge for most surgeons. PD is so complicated that even small mistakes could jeopardize the whole procedure and outcomes. With experiences of over 1000 PDs, we discuss the challenges of this procedure and strategies to deal with them.