 The primary endpoint was defined as the decrease of delayed gastric emptying. The secondary endpoints were QOL, mortality and morbidity, including pancreatic fistula, intra-abdominal hemorrhage, and intra-abdominal abscess. Patients were recruited into this study before surgery, on the basis of whether pancreatic head resection was anticipated at Wakayama Medical University HospitalWMUH for pancreatic head and periampullary disease, and appropriate informed consent was obtained. Exclusion criteria was 1 patients with severe complications which were possible to prolong hospital stay, 2 patients who were diagnosed inadequacy for this study by a physician, 3 patients with a previous gastric resection, and 4 patients without an informed consent. 