Carl Gussenbauer (1842-1903), known for many contributions to surgery, should also be noted prominently in the list of pioneers of pancreatic surgery. His successful performance of external drainage for a pancreatic cyst in 1882 was the first planned pancreatic operation. Although pancreatic surgery had been developed in animal models during the seventeenth century, surgery of the human pancreas was practically nonexistent owing to the dismal results seen with incidental pancreatic operations done early in the nineteenth century. Gussenbauer's procedure was a significant advance, representing a safe and effective solution to the pancreatic cyst problem. Gussenbauer's external drainage procedure remained the gold standard for treating pancreatic cysts until the 1920s and was still a widely practiced therapeutic option until the 1950s. With his discipline, insight, and innovative thought, Gussenbauer initiated the modern era of pancreatic surgery.