Pancreatoduodenectomy (PD) has become the standard operation for periampullary cancer and can be done with mortality of less than 5% in high volume centers (1). However the morbidity still hovers around 50% which needs to be minimized. The complications may be pancreas specific or general. The technique of PD involves the division of Gastro duodenal Artery (GDA) and resection of pancreatoduodenal arcade. In patients with celiac artery insufficiency, pancreatoduodenal arcade provides the collateral pathway supplying the celiac territory. Hence when PD is done in patients with celiac insufficiency, leads to major hepatobiliary complications and mortality (2). Current imaging technology provides information regarding celiac artery stenosis. Doppler study and GDA clamping test are mandatory in such circumstances. However the case reported here is unique because neither there was a radiological clue nor was there an intraoperative positive finding after GDA clamp test.