The authors experience of palliative treatment of advanced pancreatic cancer is reported. 32 patients underwent palliative surgical procedures of biliary decompression (20 choledochoduodenostomy and 12 cholecystoenteric bypass). In 26 patients a gastroenteric anastomosis was also performed. 8 patients underwent non surgical procedure because of their very poor conditions or short term survival. The authors point out the advantages offered by surgical treatment. Nevertheless a careful selection of patients submitted to this procedure is recommended.