Chronic pancreatitis frequently generates complications through involvement of adjacent organs. Distal common bile duct stenosis or segmental duodenal stenosis, the most frequent complications, are usually treated by resective or by-passing procedures. This study presents the experience with an organ and functionality sparing procedure in the treatment of chronic pancreatitis with predominant involvement of the pancreatic head and coexisting organ complications. Sixty-eight patients with severe chronic pancreatitis underwent duodenum preserving resection of the head of the pancreas. Fourty-one of these patients presented with organ complications: fourty with distal common bile duct stenosis, eight with duodenal stenosis, thirteen with segmental portal hypertension, and one patient suffered from a pancreatico-pleural fistula. All patients were prospectively documented. Mean follow-up was 4.1 years. 93% of the organ complications were permanently eradicated. Three patients (7%) exhibited transitory cholestasis. 88% of the patients reported complete relief of all symptoms. Duodenum preserving resection of the head of the pancreas is effective to treat severe chronic pancreatitis with predominant involvement of the pancreatic head. It also provides definitive management of associated organ complications.