Abstract 1. 1. Fifty-eight operative procedures in thirty-nine patients with chronic pancreatitis are reviewed. 2. 2. The most consistent good results were obtained in patients in whom a clear pancreatic ductal system was demonstrated at the time of surgery. 3. 3. Adequate internal drainage procedures, coupled with pancreatic ductal clearance, have yielded good results up to nine years after surgery. 4. 4. Indirect procedures, such as sphincterotomy, are successful only in early cases of pancreatitis with disease of the biliary tract. Sphincterotomy will fail in most cases in the presence of pancreatic ductal obstruction if the obstruction is not relieved. 5. 5. In the thirty-nine cases reviewed, there was one operative death and eight late deaths. In four of the eight late deaths, the patient continued the use of large amounts of alcohol. 6. 6. Our preference at the present time is clearance of the pancreatic ductal system with adequate internal drainage, and preservation of functioning pancreatic tissue whenever feasible.