Although attempts to treat pancreatic cancer were made at the end of the nineteenth century, there was no active interest in this field of surgery until 1935 when Whipple and his associates developed and popularized the technique for a two-stage pancreaticoduodectomy. Several modifications of the original Whipple operation were made in the 1940s. Total pancreatectomy and regional pancreatectomy were introduced in the surgical armamentarium against pancreatic cancer, but they did not gain wide acceptance. Pylorus-preserving pancreaticoduodectomy was introduced in 1978, but its role in the management of pancreatic cancer needs to be more clearly defined. The operative mortality of pancreatic resections has dramatically declined in large specialized centers during the last decade. A significant improvement in long-term survival was also reported in recent series. Despite the decline in operative mortality and the improved long-term survival after resection for pancreatic cancer, the overall prognosis of this disease remains dismal because of the lack of methods for early diagnosis. Future investigations should focus in the areas of early detection and more effective management approaches for locally advanced disease. @ 1995 WiIey-Liss. Inc