Summary. Improving the results of treatment in patients with liver abscesses by treatment using minimally invasive interventions. Materials and methods. We examined and treated 87 patients with liver abscesses aged 21 to 80 years. Of these, 82 patients underwent 102 surgeries. Abscess drainage was performed 95 times in 82 patients in four ways: under ultrasound guidance — to 45 (54.88 %) patients, laparoscopic - to 20 (24.4 %), under the control by angiography — 2 (2.44 %) and laparotomic access — 15 (18.28 %) to patients. 7 patients underwent resection operations. Results. So, in our analysis of the clinical picture of liver abscesses, specific symptoms were not noted. Therefore, the combination of the results of ultrasound and CT (the sensitivity of which was 98 % and 100 %, respectively) was decisive in the diagnosis and differential diagnosis of liver formations. Most often strains were sown from the abscess cavity E. coli and Kl. Pneumoniae in 43.91 % of cases. A positive effect was noted after the first minimally invasive intervention occurred in 76 (92.68 %) patients. In operated patients with laparotomic access, the main indications were, first of all: the inefficiency of external drainage under ultrasound control or the inability to use the puncture drainage method itself due to the localization of the abscess; the presence of concomitant surgical pathology, which requires surgical treatment, choledocholithiasis with complications, peritonitis Conclusions. The main task in the treatment of purulent diseases of the hepatobiliary system is the decompression and rehabilitation of the biliary tract, further antibiotic therapy, taking into account sensitivity with the active use of ultrasound-controlled drainage methods. Laparoscopic and open interventions are indicated for multiple and giant multi-chamber abscesses.

Summary. Purpose. Study of the effectiveness of permanent transmembrane peritoneal dialysis in “semi-closed” management of the abdominal cavity (BP) in patients with advanced purulent peritonitis (APP). Materials and methods. The results of treatment of 63 patients with APP with “semi-closed” administration in the abdominal cavity (BP) were analyzed. Depending on the features of BP drainage, patients with RGP were divided into two groups: comparison group (CG) — 31 patients who used traditional methods of abdominal drainage and the main group (MG) — 32 patients who underwent permanent peritoneal surgery in the postoperative period. dialysis through an artificial semipermeable membrane. Results and discussion. A study of the relationship between the levels of molecules of average weight in spent dialysis solution with the severity of multiorgan failure (MF) on the SOFA scale using Spearman’s correlation analysis revealed an average degree of correlation: 1 day after surgery - r = 0.63 (p = 0.01), for 3 days — r = 0.75 (p = 0.001). The average degree of correlation between these indicators can be explained by the fact that in addition to endotoxicosis, the severity of MF in the next day after surgery also affects surgery. This is also confirmed by the increase in the correlation coefficient by 3 days, when the degree of influence of the operating aid on the severity of MF decreases. The postoperative period was complicated in 14 (22.2 ± 5.2 %) patients with APP: in CG in 10 (32.3 ± 8.4 %) cases in MG - in 4 (12.5 ± 5.8 %) p = 0.059). Mortality of patients with APP at “semi-closed” management of an abdominal cavity made 19,0 ± 4,9 %: in MG — (25,8 ± 7,9) %, in MG — (12,5 ± 5,8) % (p = 0,179). Conclusions. The proposed method of peritoneal dialysis reduced the absolute risk of postoperative complications in patients with advanced purulent peritonitis by 19.8 %.