Between 1980 and 1989, 151 patients were treated for adenocarcinoma of the pancreas. One fifth of the patients underwent radical surgery whereas 1/3 had a palliative operation. Leakage from the pancreatico-duodenal anastomosis, constructed with a mucosa to mucosa technique, did not occur in patients operated with pancreatico-duodenal resection (n = 19). The postoperative lethality in this group was 5%. Median overall survival time was four months, after a radical operation 11.5 months and after a palliative operation five months. Five patients with cancer of the papillary region had a median survival time of 40 months and four patients are still alive.