Further concerns on extended radical resection of pancreatic cancer and vascular reconstruction      ZHENG Shu-sen, YAN Sheng, ZHANG Qi-yi, et al. Department of Hepatobiliary and Pancreatic Surgery，First Affiliated Hospital of Zhejiang University，Hangzhou 310003，China
Corresponding author：ZHENG Shu-sen, E-mail：shusenzheng@zju.edu.cn
Abstract    With the improvement of perioperative management，it has been safer to perform extended radical resection of pancreatic cancer (PC)，which has become the only hope to improve the survival rate of PC patients. Pre-operative assessment using 3-dimensional CT reconstruction of the vascular variation and the extent of tumor invasion directly affect the success of surgery. It has become a routine procedure of excision and reconstruction of the portal vein or superior mesenteric vein when it had been involved. Whether graft implantation，splenic vein ligation or reconstruction depends on the length of resected vessel. Graft choice of autologous，synthetic or allogenic vessels varies with individual surgeons. When celiac artery，hepatic artery or superior mesenteric artery were involved by PC，it is high risky to perform artery resection and reconstruction. Support of expert microsurgical technique would help to make the complex pancreatic resection a safer procedure，so that patients with advanced pancreatic cancer is expected to get long-term survival.