In addition to hematogenous and lymphatic metastasis, pancreatic head cancer is highly prone to nerve invasion, and even invasion of the portal vein or superior mesenteric vein. Standard pancreaticoduodenectomy cannot achieve the dissection of the peripancreatic nerve plexus. At present, there is no unified standard for the surgical indications and dissection range of extended dissection combined with peripancreatic nerve plexus for pancreatic head cancer. Our center has performed extended dissection pancreaticoduodenectomy for the treatment of pancreatic head cancer for more than 10 years. The operation requires 360° complete skeletal dissection around the posterior pancreatic head, superior mesenteric artery, celiac trunk, and common hepatic artery. In recent years, laparoscopic pancreaticoduodenectomy has developed rapidly. In our center, laparoscopic radical pancreaticoduodenectomy for pancreatic head cancer follows the standards of open extended dissection, using the superior mesenteric artery first approach. The inferior pancreaticoduodenal artery is preferentially ligated and transected to cut off the arterial blood supply to the pancreatic head, and then portal vein or superior mesenteric vein resection and reconstruction are performed, which can shorten the venous occlusion time.