Clinical value of proximal dorsal jejunal vein in minimally invasive pancreaticoduodenectomy

Pancreaticoduodenectomy is the standard surgical method for treating tumors around the pancreatic head and ampulla. The management of the pancreatic uncinate during surgery has always been a technical difficulty. Bleeding and positive margins in this area directly affect the patient′s prognosis. The proximal dorsal jejunal vein (PDJV) is an important branch of the superior mesenteric vein that originates from the dorsal side. Due to its deep location, multiple anatomical variations, and close relationship with the inferior pancreaticoduodenal vein and artery, it is not only a "trap" for bleeding in minimally invasive pancreaticoduodenectomy, but also a landmark for guiding precise anatomy. Based on recent anatomical developments and clinical research results, the authors systematically review the definition, anatomical classification, and relationship with adjacent structures of PDJV, and deeply explore its triple clinical value in minimally invasive pancreaticoduo-denectomy: serving as a key anatomical marker for pancreatic uncinate process resection, as a key aspect of tumor R₀ resection, and as an important site for preventing intraoperative bleeding. Combining PDJV pre‑separation technology with arterial priority approach and other surgical concepts, the authors propose possible individualized treatment strategies. Research has shown that PDJV is not only the backbone of the dorsal pancreatic venous return, but also a key structure that affects the curative effect behind the uncinate process. Understanding PDJV and its branches may provide a new perspective for optimizing the surgical process of minimally invasive pancreaticoduodenectomy, improving surgical safety, and achieving curative effects in oncology.