The classic Whipple operation, which has changed little in its fundamental principles in over 50 years, is performed today with operative mortality rates of 5% or less. It still represents the only chance for the cure of patients with malignant periampullary diseases. However, when applied to patients with pancreatic cancer, it cures very few. It probably provides excellent palliation in many, and may find wider application for palliation since it can be done safely. Certain modifications may yet decrease the morbidity associated with the Whipple, and improve the quality of life in patients who have undergone the procedure. Improved cure rates in patients with pancreatic cancer are more likely to come from newer diagnostic and nonsurgical treatments, than from more extensive and radical resections.