On the basis of 162 cases of chronic advanced pancreatitis seen at our Department during the last 15 years the diagnosis, indications and surgical procedures are described in this paper. Quantitative and qualitative changes of pancreatic collagen in chronic inflammation were also analysed. Results of these investigations were compared with histological and ultrastructural pictures of pancreatic tissue. Amongst 162 patients, 142 (88%) were operated upon. 71 underwent pancreatectomy or pancreatoduodenectomy, 14 anastomotic procedures and rest of them various operation of the bile ducts. Overall, 18 (13%) patients experienced significant complications after resectional procedures and 6 (4%) died as well after anastomotic procedures.