Objective: To assess the clinical efficacy of the pylorus preserving pancreaticoduodenectomy (PPPD) and pancreaticoduodenectomy (PD) for carcinoma of the periampullary region and pancreatic head by means of systematic review. Methods: The studies both at home and abroad concerning PPPD versus PD for carcinoma of the periampullary region and pancreatic head were thoroughly searched. The quality of included studies was assessed according to the Cochrane systematic review method and statistical analysis of data was performed using RevMan 5.0 software. Results: Six randomized controlled studies were included, with a total of 468 patients, of whom, 232 cases underwent PPPD and 236 cases underwent PD. The results of Meta-analysis indicated that there were no significant differences between the two groups in 1-, 2- and 3-year survival rate (RR=1.20, 95% CI=0.73–1.97; RR=1.02, 95% CI=0.78–1.32; RR=0.99, 95% CI=0.84–1.16), and incidence of postoperative complications and delayed gastric emptying (RR=0.86, 95% CI=0.66–1.14; RR=1.30, 95% CI=0.69–2.45) (all P>0.05). The intraoperative blood loss and operative time in PPPD group were significantly reduced compared with PD group (WMD=–527.21, 95% CI=–1044.05––10.36, P=0.05; WMD=–29.82, 95% CI=–48.05––11.59, P=0.001). Conclusion: Compared with PD, PPPD does not increase the incidence of postoperative complications, and furthermore, it reduces the intraoperative blood loss and operative time on the basis of appropriate indications