Abstract
An 82-year-old man with epigastralgia was admitted. Computed tomography (CT) showed a mass in the pancreatic head, a dilated extrahepatic bile duct, and a dilated pancreatic duct ; as well a common hepatic artery originating from the superior mesenteric artery and travelling along the ventral side of the head of the pancreas was noted on visceral angiography. Endoscopy showed a carcinoma of the ampulla of Vater. The patient had a pancreaticoduodenectomy with preservation of the replaced common hepatic artery and accessory hepatic artery. On pathology, an extrahepatic dile duct cancer with neither lymph node metastasis nor invasion to the pancreas was diagnosed. There were no postoperative complications.
