Figure 1: A 64-year-old man was diagnosed with pancreatic head cancer. The SMA abutment and the SMV involvement were detected in CECT (a, b). He was diagnosed as borderline resectable according to NCCN criteria. After 3 cycles of neoadjuvant chemotherapy with gemcitabine and S1, The tumor at pancreas head had regressed, and SMA abutment were improved but SMV encasement still existed in CECT(c, d) (partial response). He underwent laparoscopic subtotal stomach preserving Pancreaticoduodenectomy with lymphadenectomy and the SMV resection. The operation was R0 resection and the pathologic stage was T1N0 (case 9).