Abstract: D2 radical lymphadenectomy is currently the worldwide standard operation for locally advanced gastric cancer. The most common organs affected by intraoperative injuries include perigastric blood vessels, the spleen, the common bile duct, the pancreas, and lymphatic vessels. Postoperative complications usually include bleeding, lymphatic leakage, anastomotic leakage, and delayed gastric emptying. Annual volume is an important factor in the mortality and morbidity of the operation. The learning curve for the procedure involves approximately 50 operations. Adequate living anatomical knowledge and skilled surgical techniques are prerequisites for D2 lymphadenectomy.