Distal Pancreatectomy, Minimally Invasive or Open, for Malignancy (DIPLOMA)

Inclusion Criteria: * ≥ 18 years; * Elective indication for distal pancreatectomy for proven or suspected PDAC; * Upfront (without induction / down-sizing radio- and/or chemotherapy) resectable PDAC in the pancreatic body or tail; * The tumor can be radically resected via both minimally invasive or open surgery according to the local treating team; * The patient is fit to undergo both open and minimally invasive distal pancreatectomy Exclusion Criteria: * score of American society of anaesthesiologists (ASA) \>3; * A medical history of chronic pancreatitis (according to the M-ANNHEIM criteria); * Second malignancy necessitating resection during the same procedure; * Distant metastases (M1) including involved distant lymph nodes; * Tumor involvement or abutment of major vessels (celiac trunk\*, mesenteric artery or portomesenteric vein); * Pregnancy; * Participation in another study with interference of study outcomes. * Cystic lesion having undergone malignant transformation * the celiac trunk should be 5mm clear from tumor