Replaced common hepatic artery from superior mesenteric artery during pancreaticoduodenectomy.

The hepatic arterial anatomy is highly variable. A 67 year female with pancreatic mass and replaced common hepatic artery originating from the superior mesenteric artery underwent pancreaticoduodenectomy (PD). The anomalous vessel was discovered on preoperative CT scan and MRI. The vessel was dissected and preserved as it passed dorsal to the pancreas. Preservation of the blood supply to the liver and biliary tree is important after PD to prevent biliary fistula and hepatic ischaemia.