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Pancreatic cancer is one of the most deadly malignancies, and the incidence of this dismal disease has been reported to rise yearly in a global range. Currently, the cancer-related mortality rate for pancreatic cancer ranks the fourth in weste countries. However, it is predicted that by 2030, the cancer-related death rate of pancreatic cancer will rise to the second place in the United States, and the third place in Europe (1). The main reason for this change is that the treatment efficacy of top-ranking cancers, such as breast, prostate and colorectal cancer, has accomplished a significant improvement recently, while the progress in pancreatic cancer treatment is still evolving slowly. Situations of the diagnosis, treatment and prognosis of pancreatic cancer in China are similar. Overall, the treatment of pancreatic cancer is still extremely challenging, and radical resection remains the only curative therapy. Although some progress has been achieved recently in both adjuvant and neoadjuvant therapies, there is still a long way to go to improve the long-term prognosis of patients with pancreatic cancer. In this mini-review we summarize current status focusing on major advancements in surgical treatment of pancreatic cancer during the past 20 years, and highlights future prospects in the field.