153 pancreaticoduodenectomies performed from 1976 to 1995 were analyzed. The morbidity was 41.2% and the mortality 5.2%. Delayed gastric emptying (DGE) was the most common complication, and severe complications included introabdominal abscess, upper GI bleeding, and pancreatic fistula. The mortality decreased significantly from 15.6% before 1990 to 0.9% after 1990 and the morbidity decreased from 44.4% to 31.9%, and delayed gastric emptying was the major cause of mobidity after 1990 in pylorus preserving procedures.