From 1970 to 1981, 58 patients underwent surgery for pancreatic pseudocyst. The mean duration of follow-up was 37,6 +/- 34,4 SD months. The internal drainage (ID) (50% - 19/28 pat.) is the first choice therapy of pancreatic pseudocyst as it had no mortality, a low morbidity (20,7%) and a rare recurrence rate (3,4%). External drainage (ED) (18,9% - 11/58 pat.) had a high mortality (27,3%), recurrence rate (54,5%) morbidity rate (100%). 18 patients underwent an excisional therapy (31%). A total pancreatico-duodenal resection, realised because of a transmesenteric rupture of an isthmic pseudocyst was unsuccessful (1/18 patients - 5,6% mortality). Cyst recurrence (12,1% - 7 pat.) was increased by the number of urgent interventions, reflecting the higher incidence of ED in these patients (1/41 pat. - 2,4% in the elective operated pat. vs 6/17 pat. - 35.3% in the urgent operated pat.). All four fatal outcomes (6,9%) were related to gastro-intestinal (3) and intra-abdominal (1) bleeding.