The Authors report 195 cases of carcinoma of the head of the pancreas observed in the period 1983-1995. Only 94 (48%) of these patients were operated: in 32 cases an exploratory laparotomy was performed, while in 36 a bilio-digestive bypass, associated in 2 patients with a gastro-jejunal bypass was assured. In 26 patients a resection was performed: in 12 a Whipple procedure, in 6 a total duodenopancreatectomy, in 8 a pylorus preserving procedure (Traverso-Longmire). The mean survival was 2 months after laparotomy, 6 months after bilio-digestive bypass, 20 months after Whipple procedure, 20 months after total duodenopancreatectomy, 23 months after a pylorus preserving procedure (Traverso-Longmire). The Authors believe that the Whipple procedure is the treatment of choice for the carcinoma of the head of the pancreas. Only in cases of suspected multifocality or when there is a severe nodal involvement it is advisable to perform a total duodenopancreatectomy.