Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Cancer: a Multicenter Randomized Controlled Trial

Inclusion Criteria:

* Eastern Cooperative Oncology Group (ECOG) performance score 0-2
* Pancreatic ductal adenocarcinoma that is pathologically confirmed or shows characteristic radiologic features
* Patients with resectable pancreatic cancer at the time of surgery (Including borderline resectable pancreatic cancer at the time of diagnosis or Locally advanced pancreatic cancer after chemotherapy or radiation therapy)
* Lesion (within pancreatic body and tail) is located to the left of the left branch of the hepatic portal vein
* No remote metastasis in preoperative imaging and not adjacent to the superior mesenteric vein, superior mesenteric artery, and abdominal artery
* Patients without invasion of adjacent organs other than the left adrenal gland and mesocolon
* Patients with informed consent

Exclusion Criteria:

* Patients with remote metastasis at the time of diagnosis of pancreatic cancer
* History of other malignancy (Inclusive if there is no evidence of recurrence after 5 years of treatment)
* In the case of invasion of other organs other than the left adrenal gland and mesocolon
* Where major vascular resection, such as the portal vein or abdominal artery, is required to secure negative resection
* Recurrent pancreatic cancer
* Patients with underlying diseases at high risk of general anesthesia
* Preperitoneal or other organ metastases found during surgery
* In case of previously undergone pancreatic resection
* Other subject whom the investigator deems inappropriate