{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:02:19Z","timestamp":1789610539779,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extensive vascular involvement remains a major challenge in the surgical management of borderline and locally advanced pancreatic ductal adenocarcinoma (PDAC). Temporary mesocaval shunting (tMCS) may facilitate resection in cases of mesenteric venous occlusion or collateralisation and improve exposure of the superior mesenteric artery; however, its use in pancreatic surgery is rarely reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective case series of patients with borderline or locally advanced PDAC who underwent curative\u2010intent resection with intra\u2010operative tMCS between 2017 and 2022. Demographics, perioperative outcomes, post\u2010operative complications and survival were analysed using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six patients underwent pancreatectomy with tMCS (three pancreaticoduodenectomies, three total pancreatectomies). Median age was 58.5\u2009years. All shunts used cryopreserved cadaveric iliac vein grafts. Median length of stay was 13\u2009days. Two patients (33%) developed Clavien\u2013Dindo grade \u2265III complications, including one post\u2010operative death. R0 resection was achieved in two patients (33%). Median overall survival was 24.8\u2009months (33.2\u2009months excluding post\u2010operative mortality), and median disease\u2010free survival was 8\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Selective tMCS may enable resection in PDAC with extensive vascular involvement. This complex approach should be reserved for carefully selected patients at high\u2010volume centres with vascular expertise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70977","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:05:53Z","timestamp":1789607153000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporary Mesocaval Shunt: A Surgical Strategy to Facilitate Pancreatic Cancer Resection With Complex Vascular Involvement"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4757-053X","authenticated-orcid":false,"given":"Moath","family":"Alarabiyat","sequence":"first","affiliation":[{"name":"Department of HPB and Liver Transplant Surgery Queen Elizabeth Hospital Birmingham  Birmingham 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