Summary. Purpose: to improve the results of surgical treatment of patients with perforated pyloroduodenal ulcer. Materials and methods. The results of treatment of 101 patients operated on for perforated pyloroduodenal ulcer, which were treated in the surgical department for the period from 2015 to 2020, were analyzed. Results and discussion. Laparoscopic interventions were performed in 56 (55.4 %) patients with perforated ulcer. Excision of perforated ulcer by traditional laparotomy without vagotomy was used in 26 (25.7 %) patients. Suturing of perforated ulcer by traditional method without vagotomy was performed in 19 (18.8 %) patients. Complications of the early postoperative period in 8 (7.9 %) patients were surgical in nature. In 27 (26.7 %) patients postoperative complications were specific associated with the performance of dilated pyloroduodenoplasty. The largest number of postoperative complications was observed in patients who underwent suturing of the ulcer using traditional laparotomy access – 17 (16.8 %), of which general surgery – 6 (5.9 %), specific – 11 (10.9 %). Conclusions. Laparoscopic suturing of perforated ulcers is accompanied by less pronounced pain, a decrease in the number of postoperative complications, which requires greater use of endovideo-surgical technologies in this complication of peptic ulcer disease.

Summary. The aim of the study is to improve the results of treatment of patients with ulcerative gastroduodenal bleeding by using the methods of endoscopic hаemostasis. Materials and research methods. The results of endoscopic hаemostasis of 153 patients who were treated in the surgical department of the “Regional Clinical Hospital” were analyzed. Patients were examined clinically, laboratory and instrumental. Results and its discussion. For Forrest 1a, b bleeding, endoscopic clipping was used in 16 (10.4 %) patients with a visualized vessel in the bottom of the ulcer. In the studied patients of this group, there were no relapses of bleeding. Diathermy coagulation was used in 42 (27.5 %) patients. Recurrent bleeding was observed in 6 patients. Submucosal infiltration was performed in 37 (24.2 %) patients with ulcerative bleeding. Repeated bleeding was recorded in 9 patients within the next 3 hours after the intervention and in 7 patients during the first days after endoscopic hаemostasis. Combinations of endoscopic methods of hаemostasis were used in 58 (37.9 %) patients. Conclusions. The use of modern methods of endoscopic hаemostasis followed by adequate pharmacotherapy in most cases allows achieving a final stop of bleeding. Patients with a high risk of recurrent bleeding and a low surgical and anesthetic risk after successful endoscopic hаemostasis are shown surgical intervention before the development of recurrent bleeding.

Summary. Early diagnosis and timely surgical treatment of necrotizing soft tissue infection of the neck is an urgent problem of modern medicine, far from a definitive solution. The purpose of the work is to optimize the surgical treatment of patients with necrotizing infection of the soft tissues of the neck. Materials and methods. The results of surgical interventions of 76 patients with odontogenic phlegmon of the neck that were treated at the surgical ward were analyzed. Results and discussion. The essential condition for successful treatment of phlegmon neck is immediate surgery. Indications for surgery in the mediastinum should be considered in the total involvement in the necrotic process of the deep and superficial cell spaces of the neck. Preventive antibiotic therapy in patients after surgery on the neck helps to reduce the incidence of postoperative inflammatory complications and improve the quality of life of patients. Conclusions. Mortality in acute purulent odontogenic mediastinitis depends on timely hospitalization, diagnosis and early surgical treatment using extracorporeal detoxification methods.