Arterial and vena caval resections combined with pancreaticoduodenectomy in highly selected patients with periampullary malignancies.

Background/aims: To obtain a margin-negative resection and increase the indication for resection of periampullary malignancies, pancreaticoduodenectomy with a SM-PVR (superior mesenterico-portal vein resection) has been performed. However, an arterial resection, other vascular resections except SM-PVR (e.g.