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Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortali-ty in nonspecialist centres often exceeds 20 % but is around 6 % or less in specialist centres. The overall com-plication rate even in specialist centres is 18–54%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4% for fistula, 9.9 % for delayed gastric emptying, 4.8 % for bleeding, 4.8 % for wound infection and 3.8 % for intra-abdominal abscess. The median hospital stay is 13–18 days in different series. The re-operation rate varies from 4 to 9 % with a mortality rate of 23 to 67%. Major compli-cations are a significant factor in post-operative mortali-ty, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, random-ized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional spe-cialist centres. Copyright © 2002 S. Karger AG, Base