Tampa Difficulty Score

Robotic Pancreaticoduodenectomy Difficulty Scoring System

Our research team has developed a tailored robotic pancreaticoduodenectomy difficulty scoring system, an innovative tool that quantifies case severity into a point-based system, effectively stratifying cases into distinct categories for optimized surgical planning and outcomes

Preoperative Intervention

None: 0
ERCP, EUS, FNA, and/or Stent placement: (+11)

Tumor Size

<4cm: 0
≥4cm: (+1)

History of Alcoholism

None: 0
History of, or current, alcoholism/abuse: (+5)

CT with Evidence of Nodal Disease

No: 0
Yes: (+11)

Pancreatic Ductal Dilation

< 8 mm: 0
≥ 8 mm: (+5)

Result:

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Team

Tampa Difficulty Score Research Team: Sharona B. Ross MD, Michelle M. Dugan MD, Iswanto Sucandy MD, Maria Christodoulou BS, Tara Pattilachan BS, Sneha Saravanan BS, Alexander Rosemurgy MD

Preoperative Intervention

Interventions like ERCP, EUS, FNA, or stent placement can alter expected anatomy and surgical landmarks, and can potentially complicate the surgical approach and increase the difficulty of the procedure.

Tumor Size

Tumor characteristics, like size, are critical in planning the surgical approach and anticipating possible technical challenges.

History of alcoholism

History of alcoholism is crucial for surgical planning, as it may influence surgical anatomy but also affect the patient’s ability to recover from the operation due to compromised liver function or nutritional status.

CT with evidence of Nodal disease

The presence of nodal disease on CT is a critical factor in assessing the complexity of the operation, as it necessitates a more intricate and demanding procedure that includes meticulous lymph node dissection.

Pancreatic Ductal Dilation

Assessment of pancreatic duct dilation is important as it may indicate a more progressive disease state or complications like obstruction, which contribute to the technical complexity of the surgical procedure.