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Fig. 1G —44-year-old man with pancreatic adenocarcinoma. Images show sequential steps in performance of virtual Whipple procedure. Initially, margins of gallbladder are defined on sequential axial images (A) using freeform region of interest tool. Electronic sculpt function allows for subsequent electronic removal (B). Note that patient has had prior ERCP with stent placement. After electronically simulating cholecystectomy, pancreaticoduodenectomy is simulated using similar function. Reference to sagittal (C), coronal (D), and axial (E) multiplanar reformat images and volume-rendered projections (F) allow for real-time monitoring of progress and prevent inadvertent inclusion of vital structures such as mesenteric vessels. Pancreatic head, uncinate process, regional lymph nodes, and transverse mesocolon, if involved, are included and then removed electronically (G).