Vein resection in pancreatic cancer surgery

In some cases the tumour may be very close to the major blood vessels and it may be difficult for the surgeons to determine whether it is safe enough to take out the cancer just by looking at the scans.

They may decide to begin the operation with a laparoscopic procedure to make sure it is possible to safely remove the cancer before proceeding on to the full surgery.

Getting a margin of clearance around a tumour when removing it is important for prognosis. Sometimes the only factor preventing a clear resection margin is how close the tumour is to the major veins near the head of the pancreas (such as the superior mesenteric vein and portal vein).

If it is thought that the surgery to remove a section of vein will make a difference to the resection margin, then surgery is considered where sections of the vein involved are removed then joined together again using a graft from another part of the body.

Portal vein resection is performed when the vein is involved and the surgeon believes they can remove all of the cancer. This is usually when the vein involvement is small and the surgeon thinks the operation will benefit the patient. The vein can be reconstructed with stitches or using a graft. If however, an artery is involved rather then a vein, surgery will only be considered in exceptional cases after chemotherapy. Your medical team will be able to explain what is right for you.

Location of pancreas in relation to the major blood vessels:

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