The portal vein is formed from the joining of the splenic vein and the superior mesenteric vein. This confluence of veins lies underneath, in close proximity, to the head of the pancreas. A cancer of the head of the pancreas can therefore involve these structures.
In such cases, careful examination of the area (with either CT, MRI or EUS) is required. This information together with clinical and biochemical data is then collated to determine whether an operation in the form of a pancreaticoduodenectomy (Whipples procedure) is offered. If these factors are favourable then outcome from portal vein resection is equal to resections where no venous resection has taken place.
Portal vein resection is undertaken in the UK in designated Pancreatic centres.