Many patients presenting with distal pancreatic cancer are refused surgical treatment for fear of vascular invasion of the celiac trunk and common hepatic artery. In 1953, L. Appleby proposed en bloc resection of the celiac trunk together with the distal pancreatic resection and total gastrectomy for the management of regional stomach cancer. Later authors adapted the Appleby's approach for the resection of the tumours of the pancreatic head and tail (without gastrectomy). This method was later (in 1991) named after Appleby and is currently known as "modified Appleby's operation". The author reports the first experience with the use of this method in Russia (two patients). The detailed description of one of the operations is presented in conjunction with the discussion of the problems encountered during surgical treatment of the patients with regional (distal) pancreatic cancer.