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Objective The aim of this study was to investigate a new procedure with reserving the ascending part of duodenum and using Y loop of jejunal interposition for bile and pancreatic internal drainage. Methods From April 2006 to June 2012, 5 patients complicated with pancreatic calculi and very early stage of distal common bile duct malignancy were performed pancreatoduodenectomy in our department, and their clinical data were retrospectively analyzed. Results The procedure of this operation was easy and simple compared with ordinary pancreatoduodenectomy. There were no pancreatic or bile leakage, massive hemorrhage of digestive tract and intraperitoneal abdominal infection happened post-operation. The average postoperative hospital stay was 22 days. All patients were followed up for 12 months, and the survival rate was 100% . Conclusion The modified pancreaticoduodenectomy with reserving the ascending part of duodenum and using Y loop of jejunal interposition anastomosis for internal drainage can decrease the occurrence of postoperative complications and increase the safety of pancreatoduodenectomy. [ABSTRACT FROM AUTHOR]