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Summary Introduction Pancreatic ascites (PA) is an unusual and little studied complication of chronic alcoholic pancreatitis. Management is complex and is based mainly on empirical data. The aim of this retrospective work was to analyse the management of PA at our centre. Patients and methods A total of 24 patients with PA complicating chronic alcoholic pancreatitis were managed at the Lille University Hospital between 2004 and 2018. Treatment was initially medical and then, in case of failure, interventional (endoscopic, radiological and/or surgical). Data regarding epidemiology, therapeutic and follow-up data were collected retrospectively. Results Twenty-four patients were analysed; median follow-up was 18.5 months [6.75–34.25]. Exclusively medical treatment was effective in three of four patients, but, based on intention to treat, medical therapy alone was effective in only two out of 24 patients. Of 17 patients treated endoscopically, treatment was successful in 15 of them. Of the 15 who underwent surgery, external surgical drainage was effective in 13. Multimodal treatment, initiated after 6.5 days [4–13.5] of medical treatment, was effective in 12 out of 14 patients. In total, 21 patients were successfully treated (87%) with a morbidity rate of 79% and a mortality rate of 12.5% (n = 3). Conclusion PA gives rise to significant morbidity and mortality. Conservative medical treatment has only a limited role. If medical treatment fails, endoscopic and then surgical treatment allow a favourable outcome in more than 80% of patients.

Resume Introduction L’ascite amylasique (AA) est une complication exceptionnelle et peu etudiee de la pancreatite chronique ethylique. Elle requiert une prise en charge complexe, reposant principalement sur des donnees empiriques. Le but de ce travail retrospectif a ete d’analyser la prise en charge de l’AA dans notre centre. Patients et methodes Tous les malades pris en charge au CHU de Lille entre 2004 et 2018 pour une AA compliquant une pancreatite chronique ethylique ont ete inclus. Le traitement etait medical puis, en cas d’echec, interventionnel (endoscopique, radiologique et/ou chirurgical). Les donnees epidemiologiques, therapeutiques et de suivi ont ete recueillies retrospectivement. Resultats Vingt-quatre malades ont ete analyses avec une mediane de suivi de 18,5 mois [6,75–34,25]. Le traitement medical exclusif etait efficace pour 3 malades sur 4, mais en intention de traiter seuls 2 patients sur 24 ont ete traite efficacement. Dix-sept patients ont ete traites par endoscopie dont 15 avec succes. Le drainage chirurgical externe a ete efficace chez 13 patients sur les 15 operes. Le traitement multimodal, initie apres 6,5 jours [4–13,5] de traitement medical, a ete efficace chez 12 patients sur 14. Au total, 21 patients ont ete traites avec succes (87 %) avec un taux de morbidite de 79 % et un taux de mortalite de 12,5 % (n = 3). Conclusion L’AA est a l’origine d’une morbi-mortalite importante. Le traitement medical conservateur a un role limite. En cas d’echec, le traitement endoscopique puis chirurgical permet une evolution favorable chez plus de 80 % des patients.

Summary Purpose This study aimed to determine the outcome for patients who had undergone perineal hernia repair, via a perineal approach, using a biological mesh post-abdominoperineal excision (APE) for anorectal cancer. Method All consecutive patients having undergone perineal hernia repair involving an extracellular matrix of porcine small intestinal submucosa at our hospital between 2015 and 2018 were included. Follow-up clinical examinations and computed tomography scans were performed. Results Six patients were treated surgically for symptomatic perineal hernia after a median of 31 months from APE. The median follow-up after hernia repair was 11 months (interquartile range [IQR], 6–35 months). Three patients (50%) developed a recurrent perineal hernia after a median interval of 6 months. Conclusion Perineal hernia repair using a biological mesh resulted in a high recurrence rate in patients who had undergone APE for anorectal cancer.