For the patient with chronic pancreatitis and a non-dilated pancreatic duct, with uniform severe involvement of the entire gland, several operative procedures are available. One can perform a pancreaticoduodenectomy (Whipple procedure). This is a major operation and requires one enteric and two ductal anastomoses for reconstruction. In our clinic, this is the operative procedure that is most frequently performed under these circumstances. The Beger procedure, performed with some frequency in Europe but infrequently in the United States, is another option. Distal 95% pancreatectomy, an oper­ation that was performed often in the past but infrequently now, still has some appeal in that it removes virtually all of the pancreatic tissue but does not require intestinal or ductal anastomoses. Its major disadvantage is that most patients who are not insulin-dependent prior to the procedure will become insulin-dependent after this major resection. Thus, patients who are already insulin-dependent are ideal candidates. Virtually all of these patients will be exocrine-insufficient, and thus, will already be on pancreatic enzyme supplements. Another disadvantage of the operative procedure is that some pancreatic tissue is left behind; an occasional patient will continue to have mild symptoms because of the pancreatic remnant. It has proven, however, to be a procedure that can be safely performed with low morbidity and mortality and with good to excellent results in the majority of patients.