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An 82-year-old man was diagnosed with pancreatic body cancer after worsening of his diabetes mellitus. Computed tomography and staging laparoscopy revealed an unresectable pancreatic cancer with peritoneal metastasis, and systemic chemotherapy was initiated. After 76 months of chemotherapy, including up to third-line treatment, continuation of chemotherapy was difficult because of adverse events. Repeat staging laparoscopy revealed the absence of visible peritoneal metastases and negative peritoneal lavage cytology results. Therefore, distal pancreatectomy was performed as a conversion surgery. The patient has been alive 22 months postoperatively. Here, we report a case of conversion surgery after long-term chemotherapy for pancreatic cancer with peritoneal metastasis.