Objective: To assess the clinical value of the dissection of lymph nodes along the superior mesenteric artery (SMA) (14th group) and cytokeratin (CK) staining of resected lymph nodes in patients with pancreatic head carcinoma. Methods: The clinical data of 24 patients undergoing pancreaticoduodenectomy (PD) alone (PD group) and 32 patients undergoing PD plus dissection of lymph nodes along the SMA (PD+SMA clearance group) for pancreatic head cancer were analyzed. The perioperative conditions and postoperative survival rates between the two groups were compared, and the detection rates for lymphatic micrometastasis between routine pathological examination and CK immunohistochemical staining were also compared. Results: Comparing PD group versus PD+SMA clearance group, there were no significant differences in operative time [(4.5±1.03) h vs. (5.0±1.25) h], intraoperative blood loss [(1 462.5±911.73) mL vs. (1 687.5± 1 522.63) mL], length of postoperative hospital stay [(16.13±3.09) d vs. (18.25±7.17) d], or incidence of postoperative complications (8.3% vs. 9.4%) (all P>0.05). The 3-year survival rate in PD+SMA clearance group was significantly higher than that of PD group (P=0.044). The positive rate of lymph node metastasis was 6.25% (2/32) by routine pathological examination, which was increased to 21.88% (7/32) by detection of CK immunohistochemical staining. Conclusion: There is a relatively high incidence of lymphatic micrometastasis along the SMA in pancreatic head cancer patients, and CK determination can raise the detection rate of lymphatic micrometastasis. PD plus skeletonized dissection of the SMA does not increase the surgical risk or incidence of postoperative complications, and furthermore, it may improve the prognosis of pancreatic head cancer patients.