Totally laparoscopic pancreaticoduodenectomy with tangential portal vein resection

Totally laparoscopic pancreaticoduodenectomy (TLP) is an oncologically safe and feasible technique. It is performed in centers experienced in laparoscopic hepatobiliary surgery. Locally advanced pancreatic cancer with portal venous invasion seems to be a relative contraindication for laparoscopic surgery. There is no definitive data supporting such an approach. Case of a 47-year-old male patient with locally advanced pancreatic cancer determined to have portal confluence invasion in the preoperative period is reported in this study. Tumor was successfully resected with laparoscopic tangential portal vein resection (TPVR). In a selected patient with locally advanced pancreatic cancer, TLP with TPVR appears to be a safe and viable procedure when performed in high-volume centers with experience in laparoscopic hepatobiliary surgery.