“Due to the close anatomical relationship between the superior mesenteric vein/portal vein (SMV/PV) and the posterior neck of the pancreas, venous involvement by tumor or
inflammation occurs frequently. SMV/PV involvement was historically considered a sign of advanced pancreatic cancer; however, surgeons, seeking to expand the number of
patients who could benefit from pancreatectomy for cancer, introduced en bloc venous resection. An early pioneer in this work was Fortner who in 1984 described the concept
of regional pancreatectomy with vascular resection in 35 patients. This procedure encountered high mortality (26%) and morbidity that nullified any potential survival benefit.
Over the past three decades, SMV/PV resection during pancreatectomy has grown in frequency as improved surgical outcomes were observed after careful preoperative planning
with the aid of enhanced radiographic imaging. As indications for venous resection during pancreatectomy were refined, observational studies validated the safety of SMV/PV resection.”

“The intimate anatomic relationship between the pancreas and the portomesenteric vascular axis often results in venous involvement by pancreatic inflammation or pancreatic neoplasms. The now outdated term of resectability has evolved over the past few decades as portomesenteric vascular invasion by tumor or infiltration by inflammation is no longer
considered a contraindication to operative resection. Up to 30% of patients undergoing pancreatic resection for cancer require portal or superior mesenteric vein resection
in order to accomplish complete tumor clearance. Portomesenteric venous resection achieves higher complete resection rates with negative margins without significantly increased mortality and morbidity.”

Roch, Alexandra M et al. “Portal Vein Thrombosis After Venous Reconstruction During Pancreatectomy: Timing and Risks.” Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract vol. 26,10 (2022): 2148-2157. Full Text for Emory Users