目的总结壶腹周围癌行胰头十二指肠切除术早期并发症的防治经验。方法对我院１９５７－１９９４年１４１例胰头十二指肠切除术病例进行回顾分析。结果全组手术早期并发症计６９例，发生率４８９％。胰漏７２％，胆漏１１６％。手术死亡１３例，手术死亡率９２％。结论胰漏的预防关键在于胰腺残端游离充分，吻合层次精确，张力小，胰管常规引流，胆肠与胰肠吻合口相距１０ｃｍ为宜。一旦发生胰漏，充分引流非常重要，ＴＰＮ可以提高其治愈率。胆肠吻合放置支撑引流是必要的。术中仔细止血，减少输血量，是防止出血及休克的重要措施。消化道重建以Ｃｈｉｌｄ术式为佳。 Objective To summarize the prevention and treatment experience of early complications of pancreaticoduodenectomy for periampullary cancer. Methods A retrospective analysis of 141 cases of pancreatic head duodenal resection in our hospital from 1957 to 1994 was conducted. Results The total operative complications in 69 cases were 48.9%. Pancreatic leakage was 72% and bile leakage was 116%. Thirteen patients died after surgery, and the surgical mortality rate was 9.2%. Conclusion The key to the prevention of pancreatic leakage is that the pancreatic stump is free, the anastomosis level is accurate, the tension is small, the pancreatic duct is usually drained, and the anastomosis between the bile intestine and the pancreatic intestine is 10 cm apart. Once pancreatic leakage occurs, adequate drainage is very important and TPN can increase its cure rate. Biliary and intestinal anastomosis to support drainage is necessary. Intraoperative careful hemostasis and reduced blood transfusions are important measures to prevent bleeding and shock. The reconstruction of the digestive tract is best done with the Child technique.