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The Whipple procedure was established in 1935 as the prototype for resection of the pancreas head. In the more than half-century following that landmark, refinements in surgical technique and development of new technology have led to improved mortality and morbidity rates of pancreatoduodenectomy for the treatment of a number of benign and malignant diseases. Consequently, there has been an increase in the number of patients undergoing the procedure and in the number of institutions where it is performed, and basic techniques have been greatly modified to accommodate specific conditions. As procedures for pancreatoduodenectomy have evolved rapidly, new problems have arisen. The International Symposium on Pancreatoduodenectomy, held in Tokyo in November 1995, provided a forum for specialists and practitioners from 24 countries to share their accumulated experience and expertise in the field and to discuss current problems. The proceedings of the symposium, in the papers collected in this volume, are a valuable source of information for surgeons and all others who are concerned with diseases for which pancreatoduodenectomy is indicated.