Abstract: Pancreaticoduodenectomy is the main treatment method for pancreatic head carcinoma and periampullary cancer, and is also the only possible cure way. With the development of minimally invasive surgery, laparoscopic pancreaticoduodenectomy has been widely carried out, it even has been the routine operation in some pancreatic surgery center.The traditional approach is still the main approach for laparoscopic pancreaticoduodenectomy. In recent years, the procedure of the artery approach with its advantages has been put forward and gradually developed in laparoscopic pancreaticoduodenectomy through the continuous study and exploration. On the basis of the early arterial approach, authors′ center established an artery preferential disconnection procedure in laparoscopic pancreaticoduodenectomy, which has been named arterial first approach.