Pancreaticoduodenectomy in a patient with a rare celiac trunk and hepatic artery anomaly, a case report from Syria.

Pancreaticoduodenectomy is still one of the biggest and high complicated surgeries. It still has high morbidity and mortality rates. liver receives its blood supply from one hepatic artery a branch of the celiac trunk However variations of hepatic and celiac trunk are not rare. We present a case of a 60-year-old patient who underwent pancreaticoduodenectomy for ampulla tumor in which there were some rear anomalies. Angiographic CT after procedure confirmed the absence of celiac trunk, the absence of left gastric, the splenic artery arising from aorta directly and common hepatic artery arising from superior mesenteric artery. These anomalies are not considered contraindication and should not be. with good surgical experience the procedure may be done safely giving the patient his last choice to fight the disease.