The article traces the evolution of pancreaticoduodenectomy (Whipple procedure) from the 1960s to the early 2000s, through the experience of a single surgeon performing 1000 consecutive operations. Initially, the operation was infrequent due to high hospital mortality ( around 25%) until the 1980s and 1990s, when high-volume centers developed, leading to a significant drop in mortality and improved outcomes. Between March 1969 and May 2003, the median operative time decreased from 8.8 hours in the 1970s to 5.5 hours in the 2000s, and postoperative length of stay dropped from 17 days to 9 days. The overall 5-year survival rate for adenocarcinoma of the head of the pancreas was 18%, with higher survival rates for node-negative and margin-negative patients. The authors conclude that pancreaticoduodenectomy has become a safe and effective operation, with substantial improvements in outcomes over the past decades.The article traces the evolution of pancreaticoduodenectomy (Whipple procedure) from the 1960s to the early 2000s, through the experience of a single surgeon performing 1000 consecutive operations. Initially, the operation was infrequent due to high hospital mortality ( around 25%) until the 1980s and 1990s, when high-volume centers developed, leading to a significant drop in mortality and improved outcomes. Between March 1969 and May 2003, the median operative time decreased from 8.8 hours in the 1970s to 5.5 hours in the 2000s, and postoperative length of stay dropped from 17 days to 9 days. The overall 5-year survival rate for adenocarcinoma of the head of the pancreas was 18%, with higher survival rates for node-negative and margin-negative patients. The authors conclude that pancreaticoduodenectomy has become a safe and effective operation, with substantial improvements in outcomes over the past decades.