Background/aim: Pancreatic head adenocarcinoma represents the most aggressive digestive malignancy, which affects patients worldwide and is associated with poor outcomes especially due to the fact that most cases are diagnosed when local vascular invasion is already present.
Case report: This is a case report of a 44-year-old patient diagnosed with a borderline resectable pancreatic head adenocarcinoma invading the superior mesenteric artery. The patient was submitted to surgery, and intraoperatively the mesenteric artery invasion was found. A pancreatoduodenectomy en bloc with superior mesenteric artery resection was performed while the continuity of the arterial structure was re-established by placing a cadaveric graft.
Conclusion: In selected cases, extended arterial resections might be needed in order to achieve negative resection margins and therefore, to improve the chances of long-term survival.
Keywords: Pancreatic head adenocarcinoma; radical resection; reconstruction; superior mesenteric artery invasion.
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