Abstract: Objective To explore the clinical application of anterograde mesenteric artery（SMA）technique first in pancreaticoduodenectomy（PD）. Methods The clinical data of 146 cases of PD patients in our hospital in January 2012～2017 December were analyzed retrospectively.According to the inclusion criteria，the clinical data of 60 patients were further analyzed，and 2 groups were divided：the study group（n=30）：anterograde anatomy of SMA first；the control group（n=30）：no anterograde anatomy of SMA first was used. Results The study patients' operation time（382.1±63.9）min，time of hospitalization（14.6±1.2）d，ICU time（2.3±0.8）d，intraoperative bleeding（190.2±192.0）ml，blood transfusion rate 8（26.7%） were significantly lower than those of the control group，which were （443.6±49.2）min，（18.4±2.0）d，（4.9±0.8）d，（373.0±362.6）ml，66.7%（20/30），respectively（P＜0.05）. Conclusion Anatomic SMA first technique can significantly shorten the operation time，time of hospitalization and ICU time for tumor invasion of the superior mesenteric vein，and reduce the amount of bleeding，blood transfusion rate.

Key words: arteria mesenterica superior, pancreaticoduodenectomy