Aggressive tumor biology is the main characteristic of pancreatic cancer, in Germany the fourth leading cause of cancer death for females and the fifth leading cause for males. Due to late occurrence of symptoms and aggressive tumor growth, pancreatic cancer has equal incidence and mortality. Most malignant pancreatic tumours are ductal adenocarcinomas (85%). Surgical resection is the main therapeutic modality for pancreatic cancer, even though only a fraction of patients can undergo complete resection. Prognosis of pancreatic cancer remains poor even in completely resected patients; however, multimodal regimes might improve prognosis. Additionally, advances in surgical technique and perioperative management have reduced operative mortality and morbidity, especially in high-volume centers.