In general, venous resection during PD has been deemed relatively safe when appropriate patient selection is utilized [19], but reports of postoperative compli­cation rates have been mixed. Single-center studies have found no difference in the rates of perioperative 30-day [9, 10, 13, 15, 16, 20, 27] and in-hospital [13, 14] mortality in patients undergoing venous resection compared to standard procedure. These single-center studies have also demonstrated comparable rates of postoper­ative morbidity, including pancreatic fistulas, postoperative hemorrhage, delayed gastric emptying, intraabdominal abscesses, anasto motic leak, and wound infec­tions [9–12, 14–16, 27]. Two meta-analyses found no differences in perioperative morbidity or mortality following pancreatectomy with or without venous resection [17, 18]. However, several larger studies noted significant differences between groups, with one retrospective database review finding increased overall morbidity and 30-day mortality for patients undergoing vascular resection [21 results should be interpreted cautiously due to the study’s retrospective nature and the heterogeneous patient population included, as discussed previously [ 9]. The most recent and largest meta-analysis also noted a slightly increased mortality rate (risk difference of 0.01) and increased overall morbidity for patients who underwent VR, as well as higher rates of reoperation and postoperative bleeding [23]. Appropriate selection criteria and careful operative planning are crucial for maxi­mizing benefit to patients presenting with more advanced disease with venous involvement [24].