Purpose: Arterial involvement of pancreatic ductal adenocarcinoma (PDAC) has long been considered a poor prognostic indicator. Our multidisciplinary group of hepatopancreatobiliary and vascular surgeons describes a technique of superior mesenteric artery divestment using an endovascular stapler during pancreatoduodenectomy (PD) to strip infiltrated periadventitial neuro-lymphatic tissue from the adventitia, allowing for tumour clearance without risky arterial resection. Its safety and efficacy are yet to be formally established; hence we aim to demonstrate that the addition of peri-arterial divestment to the standard practice of portal or superior mesenteric venous resection during PD yields similar outcomes to venous resection alone. Methodology: A prospective database was interrogated to identify consecutive PDAC patients undergoing PD and venous resection with or without periarterial divestment (VRAD vs VRO) between 2012 and 2023. Primary endpoints were postoperative outcomes , resection margin and survival. Using STATA V16.0, postoperative complications and length of stay (LOS) were compared by regression adjustment and propensity-score matching, margin involvement using chi-squared analysis, and survival data with the log-rank test. Results: PD with venous resection was undertaken in 156 patients during the study period: (33 VRAD and 123 VRO). Patients in the VRAD cohort were more likely to have locally-advanced disease (42 vs 28%, P<0.001). The VRAD cohort experienced similar perioperative complication rates (β (SE) 0.13 (0.13), p=0.35) and LOS (β (SE) -0.77 (2.2), p=0.73). Rates of R0 resection were similar between VRAD and VRO (82 vs 69%, p=0.15). Overall and progression-free survival were not significantly lower in the VRAD cohort (25 vs 30mo, p=0.10, 21 vs 25mo, p=0.44). Conclusion: Periadventitial divestment during PD for PDAC is safe and effective when performed in conjunction with venous resection even when employed in advanced disease.