Background and Aims: Pancreatic fistula is a common complication after pancreatectomy, which can lead to abdominal hemorrhage or infections and even death of the patients. Laparoscopic pancreatoduodenectomy (LPD) is a widely used pancreatic surgery. Compared with traditional open surgery LPD has the advantages of shorter hospital stay, lower blood loss and higher overall long-term survival rate, but it still has a high incidence of postoperative pancreatic fistula. Pancreaticojejunostomy for digestive tract reconstruction is closely related to the serious complications such as postoperative hemorrhage and pancreatic fistula, which is also a key point being focused on and continuously improved. Among many pancreaticojejunostomy methods, anastomosis of the pancreatic duct and jejunal mucosa is a widely accepted anastomotic method in the world at present time. However, pancreatic duct-to-jejunal mucosa anastomosis has a significant degree of technical difficulty during LPD, and the risk of pancreatic fistula is still high. Imbedding pancreaticojejunostomy is a new anastomotic method developed by the author's team after years of exploration and practice. The purpose of this study was to evaluate the clinical value of this method in reducing the incidence of pancreatic fistula after LPD. 
Methods: The clinical data of 69 patients who received imbedding pancreaticojejunostomy during LPD from January 2018 to December 2018 were reviewed. The general data (age, sex), perioperative variables (total operative time, operative time for pancreaticojejunostomy, intraoperative blood loss, postoperative complications such as pancreatic fistula, bile leakage, bleeding, abdominal infection, and pathological results) were collected and analyzed. 
Results: LPD was successfully performed in all the 69 patients, and 4 patients received a combined portal vein/superior mesenteric vein resection and (or) repair. The total operative time was (264.5±27.2) min, the operative time for pancreaticojejunostomy was (25.7±7.2) min, and the intraoperative blood loss was (85.5±19.5) mL. Postoperative pancreatic fistula occurred in 2 patients, including grade B and grade C pancreatic fistula in each case; postoperative bile leakage occurred in 1 patient (1.4%), which healed after non-surgical treatment, such as strengthening the nutrition and inhibiting the secretion of digestive fluid; postoperative abdominal hemorrhage occurred in 2 patients (2.8%), of whom, the bleeding was control in one case by intravenous infusion of hemostatic drugs and blood transfusion, and in the other case by intravenous infusion of hemostatic drugs, blood transfusion and interventional therapy; abdominal infection occurred in 1 patient (1.5%), which was related to pancreatic fistula, and was cured by adjusting abdominal drainage tube and abdominal puncture drainage tube. The average length of postoperative hospital stay was (15.7±1.3) d. The postoperative pathology showed that there were 23 cases of pancreatic head cancer, 6 cases of pancreatic serous cystadenoma, 3 cases of solid pseudopapilloma, 1 case of intraductal papillary mucinous tumor, 21 cases of duodenal papillary carcinoma, 7 cases of ampullary carcinoma and 8 cases of distal common bile duct carcinoma.
Conclusion: Imbedding pancreaticojejunostomy can effectively reduce the incidence rates of pancreatic fistula and other related complications after LPD, which is more suitable for laparoscopic operation, and is a reliable method of pancreaticojejunostomy. So, it is recommended to be widely used in clinical practice.