The Beger procedure has been used successfully to treat patients with severe chronic pancreatitis and enlargement of the pancreatic head. The operation, developed by Dr. Hans Beger in Germany, involves removing almost all of the head of the pancreas, saving the duodenum, stomach and bile duct. In his initial report, Beger reported that 77 percent of his patients were free of abdominal pain and that 67 percent returned to work. Although successfully used by Dr. Beger and his associates, the operation has not yet found widespread use in the United States. We typically use the Whipple procedure in managing severe chronic pancreatitis with enlargement of the head of the pancreas. We use the Beger procedure in selected patients when the pancreatic ducts are not dilated and the pancreatic head is not enlarged.