Portal vein involvement is the most common reason that pancreatic tumors (without metastases) are thought to be unresectable. However, when appropriate expertise and experience are present, this may not be true. This technique of “en-block” resection of the portal vein with the pancreas is implemented in a very limited number of centers all over the world and requires very advanced experience in pancreatic surgery. We have utilized this technique in several patients, helping them to get rid of tumors that are conventionally considered impossible-to-remove.
Cancer of the head and body of pancreas, which is infiltrating the portal, superior mesenteric and splenic vein, in great extent. Conventionally, it is considered «unresectable».
The picture shows the infiltrated portion of the portal and superior mesenteric veins, and all their extent that has to be resected, so a radical and curative operation can be achieved.
After resection of a great length of the infiltrated vein, the missing vein is replaced by a graft.
The resected tumor of the pancreas, along with the infiltrated portal and superior mesenteric vein.