Because of technical difficulties attributable to the lack of appropriate techniques, the high cost of laparoscopic instruments, and the need for numerous disposable stapling devices, laparoscopic pancreaticoduodenectomy has been performed in only two patients. To solve the above problems, we devised a method of laparoscopic minilaparotomy using an abdominal wall-lift method and have successfully used it to perform pancreaticoduodenectomy with lymphadenectomy in a patient with distal choledochal cancer.