Inclusion Criteria:  Patient scheduled for elective open pancreaticoduodenectomy with Child reconstruction Age > 18 years and ≤ 85 years Full agreement to participate and written informed consent is given  Exclusion Criteria:  Emergent pancreaticoduodenectomy Laparoscopic pancreaticoduodenectomy or robotic pancreaticoduodenectomy, including transition to open approach Participant in other trials of pancreaticoduodenectomy with interfering interventions and/or endpoints Patient with severe co-morbidity(s) before surgery, including severe insufficiency in kidney, heart and/or liver, etc. Patient had medication history of corticosteroids over 3 days during last 30 days before surgery No need for pancreaticojejunostomy during pancreaticoduodenectomy (i.e. past left pancreatectomy, pancreaticogastrostomy, etc.), or pancreatic anastomosis cannot be reconstructed for any reason External stenting is used during the surgery for any reason Nasogastric tube is inserted and kept for postoperative gastric decompression In any situation that the placement of afferent loop decompression tube is medically inappropriate or not infeasible