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BACKGROUND: Mechanical jaundice is a pathological syndrome consisting in a violation of the outflow of hepatic bile through the bile ducts into the duodenum due to mechanical obstacles. The most common causes of mechanical jaundice are gallstone disease, malignant tumors, as well as cicatricial stricture of the bile duct or the large duodenal papilla of the duodenum. All this leads to the development of renal-hepatic insufficiency. Thrombohemorrhagic changes develop in the vascular bed, leading to the development of disseminated intravascular coagulation syndrome. Prevention and treatment of cholemic bleeding in case of mechanical jaundice remains one of the complex problems of hepatobiliary surgery. This article is an overview of the causes and pathophysiological changes affecting hemostasis in mechanical jaundice, as well as the main points of treatment of hemostasis disorders in patients with mechanical jaundice. AIM: This study aims to study the literature on homeostasis in patients with mechanical jaundice. SEARCH STRATEGY: To conduct a systematic search for scientific information and to achieve this goal, an analysis of scientific publications in evidence-based medicine databases (PubMed), using specialized search engines (Google Scholar) and in electronic scientific libraries (CyberLeninka, e-library) was carried out from 2005 to 2020. INCLUSION CRITERIA: Research of high methodological quality: Meta-analysis, systematic review and cohort studies, as well as publications with clearly formulated and statistically proven conclusions in English, Russian, and Kazakh. EXCLUSION CRITERIA: Summaries of reports, reports in the form of abstracts, and advertising articles. RESULTS: The mechanisms that affect hemostasis in obstructive jaundice can be considered from four perspectives: The first relates to Vitamin K deficiency in obstructive jaundice, the second describes the effect of ongoing fibrosis and cirrhosis of the liver on hemostasis, the third analyzes the relationship between infectious-septic mechanisms and the hemostasis system, their clinical significance in patients with obstructive jaundice, and the latter involves the analysis of specific factors that manifest obstructive jaundice and may themselves affect the blood coagulation system. CONCLUSION: Understanding the pathophysiology of hemostatic changes in patients with cholestasis and, more generally, liver disease is a clear way to accurate diagnosis and treatment. The combination of good knowledge with careful examination of each patient can lead to the most promising result.

Introduction: Obstructive jaundice in surgical hospitals is relatively common (2.6-23.7%). And it is one of the leader in the liver failure development with the severe homeostasis disorders appearanced. So, the analysis of the results of improving the surgical treatment of obstructive jaundice syndrome of benign genesis has been conducted from 2015 to 2019. Materials and Methods: The results of surgical treatment of 142 patients with cholelithiasis (gallstone disease) complicated by obstructive jaundice of benign genesis were analyzed: 95 females (66.9%) and 47 (33.1%) male patients. Patients were divided into two groups (experimental and control) according to the surgery method was used. Results: 5 complications (7.2%) and in 5 patients (7.2%) were fixed in the experimental group. However, only in a single complication was the II degree of severity according to the Clavien-Dindo classification. Control group had more complications cases: 18 (24.7%) in 13 patients (17.8%) ‑ (χ2=7.922, p=0.005). Mortality rate was also different: absent in the main group and 4 cases (5.5%) in the control one because of hepatic-renal failure against the background of severe intoxication (2 cases), massive pulmonary embolism (1 case), and disseminated intravascular coagulation syndrome (1 case).

Background: Approximately a third of women of fertile age suffer from chronic pelvic pain. 20% of gynecological encounters are associated with this exact problem. Within the structure of reasons of chronic pelvic pain pelvic vein incompetence (pelvic congestion syndrome) takes up to 30%, however, patients are correctly diagnosed only in 2–4% of the cases. Operative treatment helps solve the problem completely, but high disease reoccurrence and post-surgery complications rate remain relevant. Materials and Methods: 62 women with lower limb varicose vein disease aged from 22 to 48, including 20 women diagnosed with pelvic congestion, were examined and assigned into two groups (main group – 32, comparison group – 30). The main group was applied operative therapy based on the developed method of insufficient communicant vein dissection and, in case of pelvic congestion, – surgical intervention aiming at its elimination. Assessment of the result was conducted through the determination of post-surgery complications and with the varicose vein disease severity (VCSS) method.  The aim: To decrease the frequency of the lower limb varicose vein disease reoccurrence after operative therapy of the pathology.

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