I had portal vein resection performed as part of my Whipple procedure. Although imaging revealed the tumor was in close proximity and the need to operate sooner than later, it wasn’t until I was opened and the gross anatomical examination being performed that the true extent was none. The tumor was in contact with the portal vein and post surgical pathology confirmed vascular wall invasion.

On my surgical team of three were two highly experienced surgeons-one having done 1500 at that point in his career and the other several hundred. In addition, both had expertise in liver transplantation which requires vascular surgery skills. Hence the reason why the Whipple continued with portal vein resection. Had there not been anyone present with vascular surgery skills, the likelihood of the surgery being cancelled was significant.

The invasion of the portal vein was the source of stage IV spread detected a week after surgery. Aggressive treatment with Folfirinox of 24 cycles and another 22 of 5-FU/Leucovorin led to being declared cured and exceeding 11 years as a stage IV survivor and thriver.