Differential diagnosis and surgical strategies for pancreatic head mass ZHAO Yu-pei. Peking Union Medial College Hospital, Peking Union Medical College , Chinese Academy of Mecial Science, Beijing 100730, China Abstract The indications of surgical intervention for pancreatic head mass have not reached consensus among the surgeons. The most difficult is the differential diagnosis of inflammatory mass and carcinoma in pancreatic head. In recent years, the development of serum tumor marker examination, multi-slice spiral CT and endoscopic ultrasound-guided biopsy techniques provide more practical means for clinical decisions, but there are still some diagnosis can not be confirmed with non-surgical method. For these cases, exploratory laparotomy can be considered after full communication with patients and their families. And fine needle aspiration cytology for the pancreatic head mass is proposed during the procedure accompanying by pathologists for the timely processing of specimens. Chronic pancreatitis with an inflammatory mass of pancreatic head is a precancerous lesion of pancreatic cancer, and can lead to obstruction of pancreatic duct, bile duct and duodenum. The pancreaticoduodenectomy or duodenal reserved resection of pancreatic head can be performed to relieve the pain symptoms and improve quality of life of patients. However, due to the surgical trauma, and a relatively high incidence of postoperative complications, surgical indications should be strictly limited to selected cases and operations should be performed by experienced surgeon.