The technical feasibility for venous and arterial resection (AR) and reconstruction during pancreatic surgery was first reported in a substantial series by Fortner in 1983. Pancreatic ductal adenocarcinoma is the most common indication for pancreaticoduodenectomy (PD). The prognosis is poor even in potentially curative resections (R0). Different types of reconstruction techniques have been described, and the optimal technique has not yet been established. Some are in favor of reconstruction without graft. The optimal reconstructive technique in pancreaticoduodenectomy with venous resection (PDVR) in regard to late thrombosis has recently been investigated by Dua et al. finding no cases of late thrombosis in patients reconstructed with primary end-to-end anastomosis or transverse venorrhaphy.