Background <p>Locally advanced pancreatic cancer (LAPC) that involves more than 180° of contact with the superior mesenteric artery (SMA) is defined as unresectable. With advances in multimodal therapies, some cases with a favorable response to induction treatment have become candidates for resection.^{<CitationRef CitationID="CR1">1</CitationRef>} Although divestment of the SMA is now widely adopted,^{<CitationRef CitationID="CR2">2</CitationRef>,<CitationRef CitationID="CR3">3</CitationRef>} a standardized surgical technique for resecting tumors that encircle the SMA has yet to be established.</p> Patients and Methods <p>Three patients with LAPC received a median of 8 months of chemotherapy and a total radiation dose of 50.4 gray (Gy) in 28 fractions (preoperative chemoradiotherapy, CRT) with oral S-1, followed by conversion pancreaticoduodenectomy with SMA divestment. The chemotherapy regimen and timing of radiation therapy varied by case: the first case received gemcitabine monotherapy after CRT, the second case received CRT after gemcitabine plus nab-paclitaxel (GnP), and the third case received CRT after GnP, followed by a switch to modified fluorouracil, irinotecan, and oxaliplatin (mFOLFIRINOX) before surgery.</p> Results <p>All patients satisfied the ABCD criteria, which included (A) tumor shrinkage, (B) normalization of cancer antigen (CA)19-9 levels, (C) a modified Glasgow Prognostic Score of 0, and (D) a minimum of 6 months of chemotherapy.^{<CitationRef CitationID="CR4">4</CitationRef>} Each patient underwent circumferential SMA adventitia divestment and portal vein resection. Postoperative courses were favorable, with a median hospital stay of 17 days, although one patient required readmission owing to delayed pancreatic fistula. The resection margins were measured at 0.9 mm, 1.4 mm, and 4.0 mm, respectively.</p> Conclusions <p>Circumferential divestment of the SMA for LAPC can be safely performed following chemoradiotherapy, yielding favorable short-term outcomes.</p>