🔍 Key Findings

• Portal venotomy enabled successful en bloc resection of a pancreatic insulinoma and associated thrombus in the portal vein, a novel approach in veterinary literature.
• Temporary portal vein occlusion (15 min) was well tolerated, causing only transient small intestinal congestion without lasting hemodynamic compromise.
• No intraoperative hemorrhage occurred following vascular isolation and venotomy repair with 5–0 polypropylene in a simple continuous pattern.
• Postoperative complications were minimal, with only moderate pancreatitis managed medically and no portal hypertension observed on follow-up imaging.
• Histopathology confirmed insulinoma, with no initial metastasis; CT at 6 months revealed hepatic and peritoneal metastases but no local recurrence at the venotomy site.
• Portal vein luminal stenosis occurred post-repair but was clinically insignificant.
• Advanced CT imaging and 3D printed modeling significantly enhanced surgical planning and anatomical assessment.
• Surgical excision achieved good short-term outcomes, and the dog was alive and euglycemic one year later despite metastatic disease.