Pancreatoduodenectomy was performed in 131 cases for peri-ampullar carcinoma between 1957~1993. Early operative complications occurred in 61 cases, the incidence was 46.5%. 13 cases died with a mortality of 9.9%. This article discussed the prevention of three major complications namely pancreatic fistula, biliary fistula and massive bleeding.The key means in the prevention of pancreatic fistula included isolating the stump completely, minimizing the tension of anastomtic sterna,accurate suturing of the layers of anastomosis, inserting drainage in the pancreatic duct routinely and placing the anastomotic sites of choledochojejunostomy and pancreatoje-junostomy in a distance of 10 centimeters. In case pancreatic fistula occurred, drainage is very important and TPN could improve its cure rate. To prevent bile leakage, tube strut and drainage should always be used.In choledochojejunostomy, to prevent massive bleeding and shock, careful hemostasis in operation and reduction in the quantity of bank blood transfusion are important measures. Child's reconstruction of the alimentary tract is the procedure of choice.