Active_comparator: Pancreatic anastomosis

Pancreatic anastomosis (PA) will be carried out according to the techniques adopted by the participating Centre, either pancreaticojejunostomy (PJ) (i.e. dunking PJ, Cattel-Warren duct-to-mucosa PJ, Blumgart PJ) or pancreatico-gastrostomy (PG) will be considered eligible. Any mitigation strategy (i.e. ETS, use of glues/biological matrices to protect the anastomosis, surgical feeding jejunostomy, prophylactic hydrocortisone/somatostatin administration) can be used according to the Center practice. The other two anastomosis, hepaticojejunostomy and duodenojejunostomy (in case of Longmire-Traverso pancreatoduodenectomy) or gastrojejunostomy (in case of Kausch-Whipple pancreatoduodenectomy), will be carried out as usual according to each Institution's operative standards.~At least one surgical drain will be placed in the retroperitoneum in all patients.

Experimental: Total pancreatectomy

Total pancreatectomy will be carried out according to each Institution's operative standards. Preservation of the spleen will be considered whenever possible according to Kimura technique. Either ligation or preservation of gastric vessels (right/left gastric artery/vein) will be allowed according to clinical necessity but will be recorded and correlated with postoperative outcomes. The reconstruction phase will be carried out according to each Institution's operative standards. One or more surgical drains can be left in place according to surgeon's preference.