The debate about what operation to perform for pancreatic cancer will, it is hoped, soon be ended. Individual philosophies will continue to dominate reason, but whatever one's philosophy or favorite operation, a critical look at surgeon's morbidity and mortality versus his or her patients' survival must dictate what will be done. The most optimistic five-year survival rate dose not exceed 5 per cent, and I believe the mortality must be lower than this. I suspect that disappointments with total pancreatectomy and more drastic operations will continue to be registered. As is the case with many neoplasms that, unfortunately, tend to be systemic, local measures are futile. Progress will be made by looking for better ways to extirpate these lesions and by an understanding of why there is an increase in pancreatic cancer.