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Pancreatic surgeons need to be aware of, and have the expertise available to deal with, unexpected vascular anomalies encountered during pancreatic resections. We present a patient with celiac artery occlusion that was encountered unexpectedly during pancreaticoduodenectomy. As a result of this anomaly, the celiac territory is dependent on retrograde flow via collaterals from the superior mesenteric artery. We discuss the method of identifying this situation, and of revascularising the celiac trunk to prevent ischaemia of upper abdominal viscera. We highlight the implications for surgical training.

Original publication




Journal article


Ann R Coll Surg Engl

Publication Date





W15 - W17


Arterial Occlusive Diseases, Bile Duct Neoplasms, Celiac Artery, Humans, Incidental Findings, Intraoperative Complications, Ischemia, Male, Middle Aged, Pancreaticoduodenectomy, Reperfusion, Viscera