The safety and availability of laparoscopic pancreaticoduodenectomy have gradually been accepted by many surgeons in China, and it is expected to be the standard operation for periampullary tumors. Our center is one of the earliest units to perform LPD in China. After long term accumulation of experience, individualized surgical treatment strategy is selected according to the actual situation of different patients, and at the same time programmed operation process with self characteristic is gradually formed. Following the order of "bottom to top, front to back, left to right" , This process fully exerts the advantages of the endoscope, which effectively optimize the operation details, make full use of each exposed surgical field, reduce unnecessary repeated field exposure, and shorten the operation time while ensuring the quality of the operation.