ObjectiveTo explore the clinical efficacy and summarize the experience of intracapsular approach used in laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt). MethodThe clinical data of patients (from April 2020 to June 2024), including preoperative, intraoperative, and postoperative details who underwent LDPPHRt in Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were collected and analyzed. ResultsSeventy-five patients were collected in this study, including 35 males (46.7%) and 40 females (53.3%). The age was (38.3±7.9) years old, and 35 patients (46.7%) presented without symptoms. The main symptoms were abdominal pain (21 cases, 28.0%), repeated diarrhea (15 cases, 20.0%), weight loss (4 cases, 5.3%). The diameter of the pancreatic head lesions was (3.2±0.8) cm. The operative time was (210.6±23.8) min, and the blood loss was (62.4±38.1) mL. There were 18 cases (24.0%) of postoperative complications, including 6 cases (8.0%) of postoperative pancreatic fistula, 5 cases (6.7%) of haemorrhage, 4 cases (5.3%) of biliary leakage, 2 cases (2.7%) of lymphatic leakage, 4 cases (5.3%) of delayed gastric emptying, 2 cases (2.7%) of abdominal infection, 1 case (1.3%) of pulmonary infection and 2 cases (2.7%) of wound infection. The length of postoperative hospital stay was (11.7±3.3) d, and no one died within 90 d after surgery. ConclusionsThe intracapsular approach is a feasible and safe surgical procedure in LDPPHRt for patients with benign, borderline or low grade malignant tumors.