eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2019-02-25 7 2 29 32 10.12691/ajmcr-7-2-5 AJMCR2019725 article Enkhbold Ch ch_enkh103@yahoo.com 1 Chinburen J 1 Amina O 2 Chinzorig M 2 Tserendorj D 2 Department of Hepatobiliary Pancreatic Surgery, National Cancer Center, Ulaanbaatar, Mongolia School of Medicine, Mongolian National University of Medical Science, Ulaanbaatar, Mongolia Identifying the vascular anatomical variations of the operating region is essential in carrying out successful surgery, and decreasing the rate of both intraoperative and postoperative complications. Surgeons must keep in mind that arterial variation may be present in the vascular structures intraoperatively, even though it was not revealed in preoperative imaging. The present study report a case of a 51 year old woman who was diagnosed with pancreatic ductal adenocarcinoma (PDAC) with a rare variation of celiaco-mesenteric trunk originating at the level of L1. The patient underwent pancreaticoduodenectomy. The postoperative course was favorable and the patient was discharged on postoperative day 15. http://pubs.sciepub.com/ajmcr/7/2/5/ajmcr-7-2-5.pdf pancreaticoduodenectomy celiaco-mesenteric trunk pancreatic ductal adenocarcinoma