AbstractFifty‐five patients with periampullary caicinoma have been treated during a period of 32 years. This tumor represents only 0.01% of our solid tumor cases. Contrary to widely accepted opinion, periampullary carcinoma is not painless in many patients, and a palpable gallbladder is present in only 20% of patients.Twenty‐four patients had a palliative operation with a 13% immediate mortality; the mean survival of this group was 13 months. Out of 26 patients who had a radical curative operation, 18 survived the procedure; the mean survival for this group was 31 months.We believe that nearly every patient harboring a periampullary carcinoma should be considered a candidate for pancreaticoduodenectomy unless the disease is so far advanced that survival is unlikely.