Pseudocysts of the pancreas usually pose more of a diagnostic than a therapeutic problem. Once recognized, current methods of surgical drainage are generally considered to yield excellent results. Since failures in surgical management are infrequent, it is not surprising that little is known of why they occur or how they may be avoided. Pancreatic pseudocysts are relatively common on the surgical wards of large municipal hospitals. The majority are drained internally by means of transgastric cystogastrostomy or Roux-en-Y cystojejunostomy. While generally satisfied with these methods, recent experience with the need to reoperate two patients led us to a review and reevaluation of our methods of treatment. In a recent five-year period seven patients required secondary operations following surgical treatment of a pancreatic pseudocyst. An analysis of these cases has provided valuable insight into what should or should not be done in the surgery of pancreatic pseudocysts. Material and Methods We