近年来腹腔镜胰十二指肠切除术（LPD）飞速发展，随着腹腔镜技术水平的提高，LPD的手术适应证也逐渐放宽，在一些较大的中心腹腔镜下联合血管切除重建的胰十二指肠切除术也得到广泛的开展，其安全性也得到证实，但对于经验欠缺的中心LPD仍然是难度和风险较高的手术，手术难度主要分为切除难度和消化道重建难度两个部分，本文结合笔者中心经验，对LPD的难点及对策进行阐述。

In recent years, laparoscopic pancreaticoduodenectomy has rapidly developed. With the advancement of laparoscopic techniques, the indications for laparoscopic pancreaticoduodenectomy have gradually expanded. laparoscopic pancreaticoduodenectomy with vascular resection and reconstruction have been widely implemented in some major centers, and its safety has been confirmed. However, for some centers with less experience, laparoscopic pancreaticoduodenectomy remains a high-difficulty and high-risk surgery. The surgical challenges mainly consist of two parts: the difficulty of resection and the difficulty of gastrointestinal reconstruction. This article, combining the experience of our center, discusses the challenges and strategies of laparoscopic pancreaticoduodenectomy.