Pancreaticoduodenectomy (PD) is one of the most complex procedures in pancreatic surgery. The way to improve the results of treatment in patients after PD is rational perioperative management and standardization of operative techniques. Objective: to improve the results of treatment in patients after pancreaticoduodenectomy (PD). Subjects and methods. In 2014—2015, the Department of Abdominal Surgery, A.V. Vishnevsky Institute of Surgery, performed 87 PDs for pancreaticoduodenal tumors. Conventional operations were made in 72 patients; robot-assisted (RA) ones were done in 15. The patients were admitted to hospital 1—2 days before surgery; no mechanical bowel preparation was performed; water intake was limited 2 hours prior to surgery. Preoperative antibiotic and antiplatelet prophylaxis was initiated. The methodological techniques of an operation did not depend on its procedure and involved extrafascial removal of a set of organs with previous vascular isolation and lymphadenectomy. Results. The results of surgical treatment after conventional and RA operations were similar; the mean number of lymph nodes removed was 18 to 24. Specific postoperative complications, such as gastrostasis, pancreatic fistula, and arrosive hemorrhage, occurred in 29 patients and were associated with postoperative pancreatitis. Five (5.7%) patients died. Follow-ups at 1 to 25 months (median, 12 months) were made in 57 patients: 50 had adenocarcinoma (its progression was noted in 6 patients, of whom 4 died); there was no recurrence in 7 patients with neuroendocrine pancreatic tumors. Conclusion. Perioperative management of patients after PD requires its systematization, by distributing the roles of an anesthesiologist, a surgical team, and a resuscitation specialist. Rational perioperative management of patients and use of minimally invasive procedures may become one of the areas in early rehabilitation after serious surgical intervention. The introduction of a perioperative management protocol and the standardization of surgical techniques can minimize the frequency of nonspecific complications and adequately assess treatment results.