Abstract: Objective ： To analyse the effect of surgical treatment in primary duodenal adenocar-cinoma. Methods ： 23 patients diagnosed as primary duodenal adenocarcinoma in Tumor Hospital of Sun Yat-sen University and 243 cases reported by 15 domestic literatures were collected, 148 cases had been follow-up. Surgical survivals were statistically analysed with Life Table and Kaplan-Meier of spss10.0 for windows. Results ： 250 cases were treated by surgery. 135 (54.0%) of 250 were treated by pancreaticoduodenectomy, 13 (5.2%) mammary papilla adenocarcinoma by local excision, 21 (8.4%) by segmental duodenal resection, 81 had surgical palliation or underwent biopsy. Mean overall patient follow-up was 25.0±25.2 months (median: 12.0 months). Overall survivals at 1-, 2-, 3-, 5-years for 148 patients were 65.4%, 58.1%, 55.3%, 44.3% respectively. 1-, 2-, 3-, 5-years survivals for the group that underwent curative surgery were 86.0%, 75.8%, 72.0%, 59.4%. No survival differences were found between pancreaticoduodenectomy group, local excision group and segmental duodenal resection group. pancreaticoduodenectomy group, local excision group and segmental duodenal resection group compared with surgical palliation group in survival were differences. Conclusions ： Pancreaticoduodenectomy, local excision and segmental duodenal resection are appropriate for primary duodenal adenocarcinoma.The prognosis of surgical palliation is worse, multidisciplinary therapy combined with surgery should be studied further.