Surgery in chronic pancreatitis aims at sustainable relief of pain, and, if present, cholestasis, with preservation of exocrine and endocrine pancreatic function. To achieve these goals, the pacemaker of pain, usually located in the pancreatic head, should be removed, pancreatic and biliary drainage ensured, and pancreatic tissue be preserved to the largest possible extent. To that end, several combined resection and drainage procedures have been developed. This chapter describes their principles and technical characteristics, indications and contraindications, and guides optimal selection of which of the different available procedures should be performed in a given patient.