We would like to present this new method that has been implemented in our department of Hepato-biliary & Pancreatology disease at Cho Ray hospital, with the comparison to a group of surgical palliative bypass and chemical splanchnic nerve block. Methods: Between December 2003 and August 2004, 23 patients (14 men and 9 women) with a mean age of 54, 82 years (range, 31 - 73) suffering from intractable pain due to unresectable carcinoma of the pancreas or chronic pancreatitis were divided into two groups: the first group (19 patients) underwent palliative surgical bypass (biliary bypass and / or gastric bypass) and splanchnic nerve block; the second group (4 patients with advanced pancreatic cancer, 2 patients with chronic pancreatitis) underwent bilateral thoracoscopic splanchnicectomy.