Pancreatic cancer is a malignant tumor, and the number of patients who can receive curable surgery is small. Therefore, venectomy is an effective way to obtain negative surgical margins and expand the surgical population. The surgeon determines whether to perform simultaneous resection and reconstruction of the relevant vein during pancreaticoduodenectomy by preoperative imaging examination and patient characteristics. There are many options for reconstructing the vein after tumor resection, which are mainly related to the relationship between tumor and vein and the choice of surgeon. Pancreatoduodenectomy combined with venous resection and reconstruction may lead to more positive surgical margins and higher incidence of complications. Adjuvant therapy has become the standard treatment for pancreatic cancer, and neoadjuvant therapy is recognized for its role in venous invasion. Genomics and information technology may provide a new way of diagnosis and treatment for future surgery and postoperative comprehensive treatment.