The indications and the technique of PPPD in chronic pancreatitis are presented. The steps of the operation are both shown with colored figures and video. Emphasis is placed in the differential diagnosis with malignancies and the possible technical difficulties of dissecting the superior mesenteric vein and the P.V. Our experience with over 45 PPPD for pancreatitis is summarized. Possible benefits on gastric emptying and weight gain are presented in addition to pain control.