Indocyanine Green-Guided Versus Standard Laparoscopic Distal Pancreatectomy for Pancreatic Body and Tail Lesions

Inclusion Criteria: * Age ≥ 18 years. * Body mass index (BMI) ≤ 40 kg/m². * Radiologically confirmed lesion(s) of the pancreatic body and/or tail requiring elective distal pancreatectomy, with or without splenectomy. * Lesion amenable to a laparoscopic approach as determined by the operating surgeon on preoperative CT or MRI imaging. * Eastern Cooperative Oncology Group (ECOG) performance status 0-2. * Adequate hepatic function: serum bilirubin ≤ 2 × upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × ULN. * Patients who have received neoadjuvant chemotherapy, chemoradiotherapy, or radiotherapy are eligible if resectability is confirmed on restaging imaging and at least 3 weeks have elapsed since the last treatment dose. * Ability to provide written informed consent and willingness to comply with study follow-up. Exclusion Criteria: * Known allergy or hypersensitivity to indocyanine green (ICG), iodine, or iodinated contrast agents. * Uncorrected coagulopathy (international normalized ratio \> 1.5 or platelet count \< 80 × 10⁹/L). * Pregnancy or breastfeeding. * Prior major upper abdominal surgery precluding safe laparoscopic access (for example previous pancreatectomy or gastrectomy) as judged by the surgeon. * Presence of distant metastases or locally advanced disease requiring vascular resection at the time of surgery. * American Society of Anesthesiologists (ASA) physical status classification IV or V. * Severe hepatic…