ObjectiveTo evaluate the effects of duct-to-mucosa pancreaticojejunostomy (dmPJ) and invagination pancreaticojejunostomy (iPJ) during pancreaticoduodenectomy (PD) on postoperative outcomes. MethodsPubmed, The Cochrane Library, Embase, Wanfang and CNKI database were searched to identify randomized controlled trials (RCTs) evaluating different type of pancreaticojejunostomy during PD. The literatures were screened according to inclusion and exclusion criteria. Quality assessment was conducted according to Jadad scoring system. ResultsNine RCTs were included, 1 032 patients were recruited, including 510 patients in dmPJ group and 522 patients in iPJ group. Meta-analysis indicated that there were no significant differences between two groups in terms of the incidence of pancreatic fistula in total (OR=0.95, P=0.78), clinical relevant pancreatic fistula (OR=0.78, P=0.71), overall morbidity (OR=0.93, P=0.60), perioperative mortality (OR=0.86, P=0.71), reoperation rate (OR=1.18, P=0.59), and length of hospital stay (WMD=-1.11, P=0.19). ConclusionDmPJ and iPJ are comparable in terms of pancreatic fistula and other complications.