Concomitant major vessel resection in pancreatic adenocarcinoma

Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association with comparatively better pathologically negative surgical margins and postoperative survival. We have discussed the clinical relevance of concomitant major vessel resection mainly focusing on indications for such resection with borderline resectable tumor associated with chemoradiotherapy, distal pancreatectomy with en bloc celiac axis resection for pancreatic body and tail cancer, and adjuvant surgery for initially unresectable pancreatic cancer.