Modified Single-Incision Plus One-Port Versus Conventional Five-Port Laparoscopic Pancreaticoduodenectomy for Nonpancreatic Periampullary Adenocarcinomas

Inclusion Criteria:

* Age 18 years or older and younger than 75 years.
* Histopathologically confirmed non-pancreatic periampullary carcinoma, or a high clinical suspicion of non-pancreatic periampullary carcinoma when preoperative pathological confirmation is unavailable.
* Determined by preoperative multidisciplinary team evaluation to require pancreaticoduodenectomy.
* Able to understand and comply with study procedures.
* Able and willing to provide written informed consent before any study-specific screening procedure.
* Expected to benefit from therapeutic pancreaticoduodenectomy according to applicable clinical guidelines.

Exclusion Criteria:

* Distant metastasis, including peritoneal, hepatic, distant lymph node, or other organ metastasis.
* Requirement for distal, central, or total pancreatectomy, or another palliative procedure.
* Preoperative American Society of Anesthesiologists physical status classification of 4 or higher.
* Concurrent malignancy other than the target cancer.
* Pregnancy or breastfeeding.
* Severe psychiatric disorder that would interfere with study participation.
* Receipt of neoadjuvant chemotherapy or radiotherapy before surgery.
* Vascular invasion requiring vascular resection, as determined by the multidisciplinary team based on preoperative abdominal imaging.
* Body mass index greater than 35 kg/m².
* Participation in another clinical trial within the previous 3 months.