ObjectiveTo investigate the advantage of superior mesenteric artery approach in laparoscopic pancreaticoduodenectomy (LPD) combined with superior mesenteric vein (SMV)-portal vein (PV) resection and reconstruction. MethodThe operation process of a pancreatic head cancer patient with SMV-PV invasion admitted to the Second Affiliated Hospital of Chongqing Medical University in April 2022 was summarized. ResultsThe resection and reconstruction of SMV-PV during the LPD through the right posterior approach and anterior approach of superior mesenteric artery was completed successfully. The operation time was 7.5 h, the intraoperative blood loss was 200 mL, and the SMV-PV resection and reconstruction time was 20 min. The patient was discharged with a better health condition on the 9th day after operation. ConclusionFrom the operation process of this patient, the arterial priority approache is a safe and effective approach in the resection and reconstruction of SMV-PV during the LPD.