【Abstract】 Objective To investigate the preoperative and intraoperative evaluation and the operative methods of pancreaticoduodenectomy combined with resection of involved blood vessel. Methods The materials of 226 cases of carcinoma of head of pancreas, which were collected from January 2002 to June 2005, were assessed according to the T-grade evaluative method and were summarized into a more accurate method of preoperative and intraoperative evaluation and an operative method of the pancreaticoduodenectomy combined with vascular resection. The statistical analyses were performed by SAS 6.12 Stat software package with χ2 test for categorical data. Results The coincidence of every preoperative evaluations on pancreaticoduodenectomy with T-grade method were more than 85.00% and the accurate rate of evaluation on relationship between tumor and blood vessel was 80.97%. As the degree of T-grade increased, the proportion of requiring pancreaticoduodenectomy combined with vascular resection increased significantly as well (P＜0.001). All operations were smoothly done and the reconstruction of removed vascular took 12 to 46 minutes. The complication rate and the mortality rate of perioperative period were 19.61% and 1.96%, respectively. Conclusion With more practice, experience and the advanced imaging technology, it is possible for professional surgeon to evaluate more accurately on the pancreaticoduodenectomy combined with vascular resection by using the preoperative T-grade method. T-grade evaluative method is useful for operator to assess the indication accurately and to design the operative schedule reasonably. Accurate operational evaluation and careful operation are also important for pancreatoduodenectomy combined vascular resection.