title: Clinical Impact of Structured Follow-up After Pancreatic Surgery.
abstract: Structured follow-up after surgery for pancreatic ductal adenocarcinoma (PDAC) remains controversial and is currently not recommended due to a supposed lack of therapeutic consequences. Furthermore, it is not clear whether noncancer patients after pancreas resection need to be seen in the clinic on a regular basis. The present study analyzed how follow-up after pancreatic surgery affected postoperative treatment and long-term outcomes.
  
  
  
  Data of all postoperative visits in a specialized outpatient clinic for pancreatic diseases were analyzed for a 1-year period with regard to symptoms, diagnostic procedures, and therapeutic consequences.
  
  
  
  Six hundred eighteen patients underwent 940 postoperative follow-ups. Nearly half of them needed a change of medication due to altered pancreatic function. In 74 (40%) of 184 resected PDAC patients, recurrence (local or systemic) was detected during follow-up, although only 19 of these had shown associated symptoms (26%). In all patients with recurrence, a cancer-directed treatment was induced. Eleven (69%) of 16 patients with isolated local recurrence were referred for reresection.
  
  
  
  Follow-up examinations are a substantial part of the clinical management after pancreas resections. Follow-up is particularly important for PDAC because recurrence is often asymptomatic, but its detection allows for therapeutic interventions and potentially improved prognosis. This should be implemented in future guidelines.
authors.affiliation: From the *Department of Surgery, University of Heidelberg, Heidelberg; †Department of Orthopedics, Neckar-Odenwald-Kliniken, Mosbach, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Tjaden
authors.forename: Christoph W
authors.initials: CW
authors.lastname: Michalski
authors.forename: Oliver
authors.initials: O
authors.lastname: Strobel
authors.forename: Nathalia
authors.initials: N
authors.lastname: Giese
authors.forename: Anne-Kathrin
authors.initials: AK
authors.lastname: Hennche
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.forename: Thilo
authors.initials: T
authors.lastname: Hackert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult