Relief of abdominal and back pain in patients with pancreatic cancer or chronic pancreatitis is a complex clinical problem that remains the primary focus for many disease management decisions. Pancreatic denervation to interrupt the flow of painful stimuli from the pancreas through the central nervous system has conceptually intrigued surgeons since its initial report by Mallet-Guy in 1943. It can be accomplished either through ablation of the greater splanchnic nerves as they traverse the chest carrying impulses from the celiac ganglion to the central nervous system (splanchnicectomy) or by direct resection (ganglionectomy) or chemical ablation (neurolysis) of the celiac ganglion. In this video, we will present our operative technique for both types of pancreatic denervation, bilateral thoracoscopic splanchnicectomy and open celiac ganglion neurolysis.