OBJECTIVE To evaluate the feasibility and effectivity of "3 steps procedure" in the treatment of large pancreatic head cancer. METHODS The "3 steps procedure" consisted of decompression of jaundice by simple cholecystotomy, intervenient (intra-arterial) chemotherapy (5-FU 1 approximately 1.5 g, mitomycin 8 approximately 14 mg, cisplatin 40 approximately 60 mg and octreatide 1 mu intravenously as near the superior and inferior pancreatic-duodenal arteries as possible), and then the reasonable regional pancreatic-duodenectomy. RESULTS All 16 tumors were radically resected. Conventional and regional pancreatic-duodenectomy was done in 7 and 9 patients, respectively; of the later group, artificial prosthesis for portal vein bridge was done in 3 patients, end-to-end anastomosis in 4 and repair after partial resection of invaded vessel wall in 2. CONCLUSION The "3 steps procedure" is feasible and effective in the treatment of large pancreatic head cancer.