Total pancreatectomy is recommended to improve the poor prognosis for patients with pancreatic cancer. Several factors support the use of this method as the best chance of cure: no cancer is left behind at the line of pancreatic resection, radical operation in case of multicentric or diffuse pancreatic carcinoma, more radical lymphadenectomy, no complications relative to the pancreaticojejunal anastomosis, and, primarily, longer survival rates. Operative treatment must be individual and depend on tumor stage. In case of localized operable pancreatic carcinoma, total pancreatectomy seems the best way of achieving more cures.