gressed from ureterosigmoidostomy with its high incidence of disturbances of electrolyte and acid-base balance to ure teroileostomy with its appreciably lower rate of complica

Carcinoma of the pancreas is increasing in the United States and has a grave prognosis. Surgical treatment has moved from subtotal pancreatectomy to total pancreatec tomy and now to en bloc resection and vascular replace ment. Pancreatic exocrine and endocrine insufficiency fol lowing resection add to the nutritional problems presented by this major surgery and its high complication rate. Recog nition of these problems and adequate treatment decrease morbidity and mortality. Major hepatic resection imposes metabolic problems in the immediate postoperative period that are minimized by improving preoperative nutritional status and by providing adequate postoperative support with albumin and carbohydrate. Urinary tract diversion for pelvic cancer involving the ureters and/or bladder has pro gressed from ureterosigmoidostomy with its high incidence of disturbances of electrolyte and acid-base balance to ure teroileostomy with its appreciably lower rate of complica tions.