**3. Rationale in vascular resections**

#### **3.1. Pro**

Surgeons have gradually pushed the boundaries in surgical resection thanks to the advance‐ ments in oncology and critical care. Unfortunately, PDVR has not yet been generally accepted and applied as surgical management of patients with locally advanced adenocarcinoma of the head of the pancreas, despite of the growing evidence.

#### **3.2. Cons**

Pancreatic carcinoma is characterized with high biological activity and early involvement of retroperitoneal tissue, lymph nodes, and peripancreatic blood vessels. Vascular involvement is frequently combined with invasion in neural plexus so clear resection margin could not be achieved. Vascular resections especially arterial ones add an additional level of complexity to the usually difficult pancreatic surgery without clear impact on the long‐term survival rates.
