Background and Aims: Pancreatic head cancer is the most common type of pancreatic cancer, and pancreaticoduodenectomy (PD) is the main surgical procedure for the treatment of pancreatic head cancer. However, the high incidence of complications and poor postoperative recovery are still the difficult problems in the field of general surgery. Enhanced recovery after surgery (ERAS) is an innovative concept in perioperative management of surgery developed in recent years, it has been proven to reduce postoperative complications and speed up postoperative recovery. However, the ERAS concept has not been widely implemented in PD. Thus, this study was designated to investigate the effects of using ERAS protocol on postoperative recovery and nutritional status in patients undergoing PD for pancreatic head cancer, and evaluate its application value.  
Methods: A total of 62 patients with pancreatic head cancer scheduled to undergo PD from May 2015 to May 2019 were enrolled. Using a random number table, the patients were randomly divided into ERAS group and control group, with 31 cases in each group. Patients in ERAS group received intervention measures guided by ERAS concept during perioperative period, while those in control group were treated with conventional perioperative management. The intraoperative variables, postoperative recovery parameters, incidence rates of postoperative complications, and changes in nutritional status indexes were compared between the two groups of patients. 
Results: There were no significant differences in preoperative general data and nutritional status indexes that included transferrin (TRE), prealbumin (PAB) and albumin (ALB) between the two groups of patients (all P>0.05). There were no significant differences in intraoperative blood loss, amount of the intraoperative infusion and operative time between the two groups of patients (all P>0.05). The time to first postoperative passage of flatus, first defecation and time to ambulation in ERAS group were significantly earlier than those in control group (all P<0.05). No significant differences were noted in the incidence rates of pancreatic fistula, infection, anastomotic fistula and delayed gastric emptying (all P>0.05), but the overall incidence of postoperative complications in EARS group was significantly lower than that in control group (6.45% vs. 32.26%, P<0.05). The serum levels of TRE, PAB and ALB were significantly decreased on the postoperative day 3 in both groups, but the decreasing amplitudes of them in ERAS group were significantly lower than those in control group (all P<0.05). 
Conclusion: ERAS strategy offers a good effect in patients with undergoing PD for pancreatic head cancer. It can accelerate postoperative recovery, improve the nutritional status of patients and reduce postoperative complications. So, it is recommended to be widely used in clinical practice.