A review of the literature over the last five years reveals that the results of treatment of pancreatic carcinoma have barely improved over the last thirty years, except in terms of the operative mortality which has markedly improved over the last decade. Pancreatectomy still constitutes the only, although slight, chance of cure. It must be reserved to the rare macroscopically curable cases, i.e. small tumours of the head of the pancreas, apparently confined to the pancreas. Palliative treatments should preferably be surgical. Endoscopic biliary drainage should only be performed in inoperable cases. Adjuvant radiotherapy and chemotherapy must be integrated into curative and palliative strategies. These various therapeutic modalities can only be evaluated by means of prospective studies and controlled trials.