Inclusion Criteria:  Patients diagnosed with periampullary cancer meet the following criteria:  Possibility to perform pancreaticoduodenectomy based on preoperative imaging and intraoperative exploration. The postoperative pathology is adenocarcinoma (of the ampulla of Vater, common bile duct, duodenum or pancreas)  Exclusion Criteria:  The patient has other organ's cancer beyond periampullary cancer. Patient's medical conditions contraindicate for anesthesia. The patient does not consent to participate in the study