Objective: To compare the clinical effects between two approaches for management of blood vessels during laparoscopic gastric cancer surgery. Methods: The surgical video and clinical data 187 patients undergoing laparoscopic D2 radical gastrectomy for distal gastric cancer over the past 4 years were retrospectively analyzed. According to the methods used for management of blood vessels during operation, the patients were divided into method one group (n=89) and method two group (n=98). The major part of procedure of method one was performed by the primary surgeon alone, while the procedure of method two was completed by the close cooperation between the primary surgeon and the assistant surgeon. The pre-, intra- and postoperative conditions between the two groups of patients were compared. Results: The preoperative conditions between the two groups were comparable. No statistical difference was observed in number of lymph nodes identified at pathological examination, and the incidence of associated postoperative complications between the two groups (both P>0.05), while method two group was significantly superior to method one group with regard to operative time and intraoperative blood loss (both P<0.05). Conclusion: Through the close cooperation between the primary surgeon and the assistant surgeon, management of blood vessels can be quickly completed, the time for lymph node clearance is shortened, intraoperative blood loss is reduced, and with no decrease in quality of lymph node clearance, so it is recommended to be used in clinical practice.