Objective - the comparative evaluation results of two different treatment strategies for chronic pancreatitis, complicated by bile duct and duodenal obstruc- tion.Material and Methods: The patients were divided into two groups. In the main group we used the following surgical strategy. If possible the preferred operation was pancreaticoduodenectomy. In cases unresectable pancreatic inflammatory head masses, biliary and duodenum drainage procedures were performed. In the main group 19 patients received pancreaticoduodenectomy, 5 - duodenum preserving resection and 30 drainage procedures, in the com- parative group 4 - pancreaticoduodenectomy and 29 drainage procedures (p=0,002).Results: Postoperative morbidity was higher in the main group - 20 (37%) vs 4 (12%), p=0,003. One patient died in the main group after drainage opera- tion. In follow-up in 12 patients (6 per group) were observed false negative results of biopsy and diagnosis of chronic pancreatitis had changed to pancreatic cancer. There were 4 cases of missed curable carcinoma in the comparative group and none in the group with preferred resectional surgery strategy. The quality of life was also better in the main group.Conclusion: The proposed surgical strategy takes into account the probability of false-negative diagnostic results, prevents cases of missed operable pancre- atic cancer in a remote period and gives a better quality of life.

Background: Most often pancreatic cancer is diagnosed at later stages, the average detection rate at stages III and IV in Russia is 59.5% [1]. The “gold” stan- dard for the verification of pathological processes is histological examination, but, in connection with the localization of the pancreas, obtaining tissue with the least amount of complications is difficult.Methods: It was evaluated the results of eUS - guided fine needle aspiration at pancreatic diseases with examination on the material of 124 clinical observa- tions.Results: When comparing the three different diameter needle for eUS - guided fine needle aspiration with the “gold” standard: with a histological examina- tion based on the results of surgical intervention, or with the data of a catamnesis, the accuracy of setting the correct diagnosis in the group of fine needle aspiration biopsy with 19G needle (group 1) was within the confidence interval from 80.31% to 98.41 %, in group 2 - from 92.29% to 100%, in group 3 - 100%. In 46 cases (36.5%) revealed malignant neoplasms of the pancreas, 22 persons (17.5%) with pseudocysts of the pancreas, and 18 (14.3%) patients with inflammatory pseudotumor of the pancreas.Conclusions: eUS - guided fine-needle aspiration biopsy of the pancreas with different diameter needle allow verifying the pathological process of the pancreas.

Rationale: The choice of suture material is an important factor in the formation of tracheal anastomoses. This study compares the use of synthetic absorbable suture with that of synthetic nonabsorbable suture for construction of cervical tracheal anastomoses in the rats. The work is devoted to the evaluation of bacterial tracheal contamination after performing a circular resection followed by the imposition of tracheal anastomoses in Wistar rats using a different suture material.Objective: The work was performed using 48 Wistar rats. To study the contamination of lumen and tracheal tissue after performing its circular resection, depending on the type of suture material.Results: The microflora of the trachea was analyzed depending on the type of suture material.Conclusion: The type of suture material does not affect the frequency of microbial associations. The main microorganisms are conditionally pathogenic - Citrobacter freudii, Staphilococcus epidermidis, Proteus rettgeri, escherichiae coli. The use of a non-absorbable suture results in an increase in microflora of 83.4%, while the use of absorbable suture material in 62.5%. In this regard, with surgical interventions to restore the lumen of the trachea, it is more rational to use absorbable suture material.

Aim of research To test the effect and safetythrombus aspiration procedure combining with urgent endovascular angioplastics on embolic artery of patients with acute coronary syndrome and elevated segment ST.In cases of drug and endovascular myocardial reperfusion the risk of complications decreases due to the reduction of load on infarct related artery. No serious complications such as cerebral circulation and myocardial embologenic were detected among patients with acute myocardial infarction with ST segment elevation in the group with formed thrombus aspiration. As for a group with prehospital thrombolysis, there were no deaths in it, indicating the effectiveness of thrombolysis as a preventive measure.Material and methods: We give direct results of 270 patients with acute coronary syndrome after urgent thrombus aspiration with following stenting. on embolic artery and of 90 patients after urgent angioplastics without thrombus aspiration.Results: It is proved that complete or the of evacuated thrombotic mass or mostly occlusive substance from embolic artery has positive influence on an- giophic results and is capable of dereas cases of distal embolization.Conclusion: After endovascular carring out embolic artery in thrombus aspiration groups we have complete rehabilitation of epicardial blood circulation and myocardial blush grade in comparison with groups without thrombus aspiration.

TIn modern surgical practice, foreign bodies of the digestive tract are rare causes of an acute abdomen. If there is anamnestic evidence of foreign bodies entering the digestive tract, making the diagnosis is not a difficult task. However, in the case of an erased clinical picture or differential diagnosis with intercurrent disease, diagnosis and timely surgical treatment are a significant challenge. In this case, the entry into the lumen of the digestive tract of the for- eign body (bone) was unnoticed by the patient. The clinical picture and complaints presented to patients imitated the phenomena of acute pancreatitis: there was an alcohol load anamnestically at the prehospital stage; clinically there were shingles, vomiting that did not bring relief, palpation of the infiltrate in the epigastric region and elevated laboratory markers (blood amylase). In view of the absence of ultrasound and X-ray data for the presence of a pathological process for the verification of diagnosis, a computer tomography with the finding of the cause of abdominal pains was used - a foreign body (bone) in the lumen of the intestine. Laparoscopy removal of a foreign body and suturing the perforation of the intestinal wall was performed. The outcome is recovery, which proves the validity of the use of minimally invasive technologies in the treatment of such conditions.