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.