Inclusion Criteria:  Patients older than 18 years All patients scheduled for PD for all kind of pancreatic diseases Patients able to give their informed consent Patients undergoing PD (Kausch-Whipple or Longmire-Traverso) Patients presenting two major and at least one minor criteria (Major criteria: Main pancreatic duct diameter ≤3mm; Soft pancreas. Minor criteria: Bleeding stump; Friable stump; Posterior/Eccentric duct; Invisible duct; Deep pancreas; Intraoperative acute pancreatitis; FRS 9-10) Two or more surgeons confirming eligibility PA or TP with or without spleen preservation (Kimura technique). These techniques are consistent with clinical practice; any other procedure will be a deviation from the protocol  Exclusion Criteria:  Informed consent withdrawal Impossibility to undergo surgery for any reason Main pancreatic duct of the pancreatic neck/body >3mm at preoperative imaging (CT scan or MRI) PD not performed for any reason Absence of two major criteria Absence of at least one minor criteria Absence of interobserver agreement between at least 2 surgeons More than 1 extension of resection to pancreatic neck due to pancreatic margin positivity Wrong randomization