Abstract： Objective To explore the feasibility and safety of type Ⅱ binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy and mid-segmentectumy of pancreas.Methods From November 2008 to May 2009,26 patients underwent pancreaticoduodenectomy and mid-segmentectomy of pancreas with type Ⅱ BPG reconstruction,including 13 cases of pancreatic head cancer,3 cases of duodenal adenocarcinoma,2 cases of ampullary carcinoma,4 cases of cholangiocarcinoma,1 case of bile duct cell severe atypical hyperplasia,and 1 case of stomach cancer.The process of type Ⅱ BPG was described as the following:after pancreas remnant was mobilized for 2-3 cm,a piece of sero-museular layer at the posterior gastric wall was excised and then a sero-muscular depth purse-suturing with 3-0 prolene was pre-placed (outer purse-string).Incising anterior gastric wall or opening part of the closed distal gastric stump,the mucosa layer at the seromuscular defect was incised and then purse-suture at the mucosal tube was pre-placed (inner purse-string).Through the two pre-placed purse-strings,the pancreas remnant was pulled into the gastric lumen and then posterior gastric wall was pushed backward to keep it closely in contact with the retro-peritoneal wall Thereafter,the outer purse-string was tied (outer binding)and then the inner purse-string was tied (inner binding).Results All cases underwent BPG of type Ⅱ.The operative time ranged from 3 to 5.5 hours.The postoperative hospital stay ranged from 6 to 48 days.Postoperative complications included 1 case of ascites,2 cases of delayed gastric emptying and 1 case of intra-abdominal bleeding.All cases with complications were cured after nonsurgical treatment.No mortality or pancreatic leakage occurred.Conclusions Pancreaticogastrostumy is good for accommodating a large pancreas stump.Binding technique is very helpful in minimizing the leak rate of pancreaticogastrostomy.While type Ⅰ BPG is safe and easy to perform,type Ⅱ is even safer and easier to be done.