Objective: To compare the clinical efficacy of the different pancreatico-enteric anastomosis procedures after pancreaticoduodenectomy (PD). Methods: The clinical data of 260 patients undergoing PD from March 2008 to March 2013 were retrospectively analyzed. The patients with pancreatic duct diameter ≥4 cm underwent duct-to-mucosa pancreaticojejunostomy (135 cases); of the patients with pancreatic duct diameter <4 cm, the cases with jejunal lumen less than the size of pancreatic stump underwent modified Child pancreaticojejunostomy (67 cases), while the cases with jejunal lumen equal or greater than the size of pancreatic stump underwent binding pancreaticojejunostomy (58 cases). The clinical efficacy and incidence of postoperative complications among the three groups were compared. Results: The operations were completed in all patients. The incidence of postoperative complications such as pancreatic juice leakage, abdominal infection, intra-abdominal hemorrhage and digestive dysfunction as well as the average length of hospital stay among the three groups showed no statistical difference (all P>0.05). One elderly patient died of cerebrovascular accident on the fourth day after operation, and the remaining patients were followed up for 3.2 (2–4) months, during which time no recurrence, metastasis or death occurred. Conclusion: The procedure of post-PD pancreatico-enteric anastomosis should be selected according to the pancreatic duct diameter and size of the pancreatic stump as well as the size of the jejunal lumen. The proper post-PD pancreatico-enteric anastomosis could yield favorable results.