Background and Aims: Laparoscopic pancreatoduodenectomy (LPD) has been widely used for the radical treatment of distal cholangiocarcinoma. However, the level of technical difficulty and incidence of postoperative complications of performing LPD for distal cholangiocarcinoma are still high, due to the clinicopathologic features of distal cholangiocarcinoma. So, making a self-quality control system for this operation is necessary. The aim of the present study was to explore the establishment and implementation effect of the self-quality control system of LPD for distal cholangiocarcinoma.  
Methods: A historical control analysis of the relevant clinical variables was performed between 37 patients undergoing LPD for distal cholangiocarcinoma before self-quality control system establishment from January 2013 to December 2018 (control group) and 30 patients undergoing LPD for distal cholangiocarcinoma after self-quality control system establishment (observation group). The components of the self-quality control system included: “en-block” resection for lymphadenectomy; lymph node sortation performed by surgeons after surgery; properly handling gastroduodenal artery, coronary vein, Helen's trunk and "dangerous triangle", and simultaneously paying attention to avoid the omission of the right gastric artery; ensuring the attachment of the jejunal seromuscular layer to the posterior wall of the pancreas and using 5-0 vicryl line to fix the pancreatic duct during pancreaticojejunostomy; protecting blood supply of biliary tract and using 4-0 PDS suture to complete the anastomosis during choledochojejunostomy; all-directional drainage of the anastomosis area. 
Results: There were no significant differences in baseline characteristics between the two groups of patients (all P>0.05). In terms of lymph node harvest, the proportion of cases with the number of resected lymph nodes reaching the minimum requirement of AJCC version 8 (≥12 lymph nodes) in observation group was significantly higher than that in control group (96.7% vs. 78.4%, P=0.029). The intraoperative blood loss in observation group was significantly lower than that in control group [(151.0±59.7) mL vs. (176.2±39.5) mL, P=0.042]. The overall incidence of postoperative complications in observation group was lower than that in control group, but the difference did not reach a statistical significance (26.7% vs. 37.8%, P=0.333); the incidence of postoperative bleeding in observation group was lower than that in control group, but no statistical significance was reached (3.3% vs.
 8.1%, P=0.412); there was no significant difference in incidence of pancreatic fistula between observation group and control group (23.3% vs. 21.6%, P=0.867), but the incidence rates of pancreatic fistula over grade B in observation group was significantly lower than that in control group (P<0.01); bile leakage occurred in only one patient in control group; the incidence of abdominal infection in observation group was significantly lower than that in control group (0 vs. 5.4%, P<0.01). No perioperative death occurred in both groups.
Conclusion: The self-quality control system covering each aspect of LPD for distal cholangiocarcinoma may help improve the oncological outcomes of the patients, and also reduce the postoperative complications, and thereby, ensure the safe and effective performance of LPD for distal cholangiocarcinoma.