Pictorial review of vascular involvement and complex vascular reconstructions in borderline to minimally advanced pancreatic malignancies.

Purpose: To review borderline resectability criteria for pancreatic malignancies, show examples of few surgically treated minimally advanced pancreatic malignancies, discuss various complex vascular reconstructions, and highlight the imaging appearances.

Background: Often aggressive surgical approaches are used to treat borderline to minimally advanced pancreatic malignancies in specialist centers. As abdominal radiologists it is essential to have up-to-date knowledge to distinguish such tumors with accuracy and also be well versed with the various vascular reconstructions used in such surgeries.

Imaging Findings: We will show various examples of resected borderline resectable and minimally advanced pancreatic malignancies, highlight crucial vascular involvements, describe various types of advanced vascular reconstructions, and review their standard imaging appearances. We will also briefly describe the vascular complications and highlight the importance of imaging surveillance in early post-operative period.

Conclusions: It is essential for abdominal radiologists in specialist centers where aggressive surgical approaches are used to have accurate knowledge to assess vascular involvement in pancreatic malignancies and equally to recognize and assess vascular reconstructions on imaging after complex surgeries.