Abstract: The space occupying lesions of the head of pancreas include the cancerous and inflammatory lesions. Currently, it is still difficult to detect the atypical lesions in patients before surgery through various imaging examinations that have been popular. Pathological diagnosis by preoperative and intra operative biopsy is effective and feasible, but false negative findings are potential limitations of this method. While many guideline and consensus papers have been published in China and aboard, so far, the clinical guiding and feasibility of the documents are unsatisfactory. In particular, patients are at high risk of postoperative complications after a complex pancreaticoduodenectomy. It is still the key point for surgeons to determine treatment regimens for patients with atypical symptoms or unproved malignant tumor by preoperative imaging examination and negative biopsy. Therefore, 15 experts in relevant fields from China were invited to present their opinion based on their personal clini cal experiences during a panel discussion on the space occupying lesions of the pancreas head.