Aims. The aim of the study was to evaluate the association of mortality in acute pancreatitis with clinical and simple laboratory data received on the day of admission. Patients and methods. In our retrospective study, the clinical and laboratory parameters of 99 patients with moderate and severe acute pancreatitis were analyzed. All patients were divided into two groups: deceased and survivors. Results. We did not find a significant difference in age and gender distribution between the comparison groups. However, a significant predominance of alcoholic etiology of acute pancreatitis, early hospitalization (up to 6 hours from the onset of the disease) of patients, and the number of necrotizing infected type in the deceased group were found. Concomitant pathology did not significantly differ in comparison groups. In patients from the deceased group, the total number of all complications was significantly higher than in the group of survivors-21 (100%) and 42 (53.8%) (p = 0.0001), respecting. Among the laboratory parameters determined on the day of admission, in the deceased group, there was a significant increase in stabs to 19.8 ± 9.8 and ESR, AST to 225.3 ± 47.5 U/L, urea to 11.2 ± 7.7 mmol/L, and creatinine to 173.6 ± 26.1 mmol/L. Conclusion. The alcoholic genesis of acute pancreatitis, necrotizing infected type of inflammation of the pancreas, presence of late complications, and comorbidities were significantly higher in the deceased group. The levels of stabs, ESR, AST, urea, and creatinine determined on the admission significantly dominated in the deceased group, which requires further study for the prediction of mortality of acute pancreatitis.

The aim: To analyze the frequency of complications of echinococcal cysts of the liver, the causes of recurrence and the results of surgical treatment of patients with echinococcal liver disease. Materials and methods: The results of surgical treatment of 79 patients who were hospitalized from January 2011 to JANUARY 2022 with liver echinococcosis and its complications were analyzed. Among them there were 11 men (13,9%) and 68 women (86,1%), with average age 47,5 ± 2,3 years. Complications of echinococcal cysts developed in 17 (21,5%) patients. Results: The choice of surgical intervention method was determined individually, taking into account the location of echinococcal cysts, their size, depth, proximity of important anatomical structures. 53 (67,1%) patients underwent total or subtotal pericystectomy, 8 (10,1%) patients underwent liver segment resection, 5 (6,3%) patients underwent cyst dissection with removal and treatment its cavity, PAIR method was applied in 1 (1,3%) patient. Echinococcectomy was performed laparoscopically in 12 (15,2%) patients. The use of laparoscopic surgery for echinococcosis of the liver reduced intraoperative blood loss, duration of operation, hospital stay. We did not have recurrences of the disease after radical surgery. After palliative surgery, recurrence occurred in 2 (2,63%) patients. Conclusions: Surgical interventions for urgent indications in patients with complicated echinococcal cysts of the liver increase the risk of recurrence of the disease. Pericystectomy was performed in 53 (67,1%) patients, is a radical and efficient operation for complete recovery and does not lead to recurrence of the disease. The efficiency of laparoscopic echinococcectomy has been demonstrated.

Smmary. The aim of the work was to solve the problem of preventing and choosing the method of surgical treatment of paracolostomy hernia in patients with obesity. Materials and research methods. The treatment results of 56 (100.0 %) patients with obesity operated on for paracolostomy hernia were analyzed. Men made up 27 (56.2 %) people, women - 29 (29.0 %). In all patients of this age category, except for obesity, there was a combined concomitant pathology: atherosclerotic and post-infarction cardiosclerosis — in 56 (100.0 %) cases; COPD - in 42 (69.6 %); diabetes mellitus — in 18 (26.1 %); cerebrosclerosis — in 17 (24.6 %). Surgical treatment of paracolostomy hernias was performed by 3 methods: alloernioplasty with colostomy left in the same place was performed in 16 (29.0 %) patients; allohernioplasty with colostomy moving to a new place — 22 (52.2 %) patients; 18 (18.2 %) used minimally invasive methods, of which 8 (11.6 %) using the laparoscopically-assisted method. The average duration of laparoscopic hernioplasty was (65.5 ± 5.5) minutes., With «open» methods — (45.5 ± 5.5) minutes Research results. The analysis of the results of treatment of paracolostomy hernias with three different methods was carried out; the groups were identical in terms of the number of patients. According to the duration of the operation, the laparoscopic method of alloernioplasty was longer and needed the use of general anesthesia and pneumoperitoneum, which can cause the development of a number of dangerous complications. The other two extraperitoneal methods of allogeneioplasty are more gentle, can be performed under spinal or epidural anesthesia. However, it is precisely with these methods of alogioplasty that the risk of developing local complications is high. Conclusions. In the treatment of paracolonostomy hernias in patients with obesity, the best results were obtained with laparoscopic alloernioplasty. When withdrawing a colostomy in patients of advanced and senile age, preventive alloprosthetics are recommended.

Pericardial cysts are infrequent mediastinal entities. They can mimic cardiac chamber enlargement, phrenic hernia, malignancy, bronchogenic cysts, pleurisy, dextrocardia. Diaphragmatic elevation can also be misdiagnosed in some cases. The reports about huge pericardial cyst mimicking the left diaphragmatic elevation (paralysis) are not common. The correct diagnosis of pericardial cyst can be difficult due to unremarkable complains and non-specific findings on chest radiography. In this report we have presented a rare clinical case described as the huge pericardial cyst mimicking a false left diaphragmatic paralysis. The combination of different radiological technics (CT-scans, barium esophago-gastrography etc.) are useful to correct preoperative diagnosis. Transthoracic (intercostal) accesses are the dominant to operate on patients with huge pericardial cysts.