The establishment of a medical centre for pancreatic surgery is possible according to the regulations of the German authorities. Nevertheless, there are multiple factors influencing medical quality apart from the case load of a hospital. These are a well-functioning intensive care unit and the possibility for radiological and/or gastroenterological interventions 24 hours a day. Most important is the personal motivation of the doctors and nurses in successfully supporting such a programme. So far the prospective implication on health care or medical education cannot be finally anticipated. The different independent factors of medical quality concerning pancreatic surgery have still to be identified and should reasonably influence any governmental or institutional regulations.