To evaluate the effectiveness of thoracic epidural analgesia (TEA) for prevention of post-ERCP pancreatitis (PEP). Materials and methods. Between 2015 and 2019, a randomized study of the results of endoscopic treatment in 491 patients was conducted. The first group of patients (N=247) received thoracic epidural analgesia during ERCP procedures, the patients of the second group (N=244) received a narcotic analgesic. Results. In the first (TEA) group there were no cases of pancreatic necrosis and fatal outcome, in the second (control) group in 7 (2.9%) patients were diagnosed with this adverse event, of which 3 (1.2%) patients died. A statistically significant reduction in the incidence of PEP was found due to the use of epidural analgesia in all age categories (p = 0.0004-0.0232), in women (p = 0.0000) and men (p = 0.0057), patients with jaundice (p = 0.0000), with sphincter of Oddi dysfunction (p = 0.0000), with common bile duct stones (p = 0.0004), with tumor (p = 0.0010), after biliary sphincterotomy (p = 0.0000), biliary-stone extraction (p = 0.0013), nasobiliary drainage (p = 0.0016). The study has proved the effectiveness of thoracic epidural analgesia in patients with high risk of post-ERCP pancreatitis (p = 0.0000). Conclusion. The use of thoracic epidural analgesia during therapeutic ERCP procedures is an effective method of preventing post-ERCP pancreatitis. K E Y w O R D S-therapeutic ERCP, prevention of post-ERCP pancreatitis, thoracic epidural analgesia.

To evaluate the effectiveness of preventive measures in relation to the development of acute postmanipulatory pancreatitis in patients after endoscopic transpapillary interventions. Materials and methods: In the period from September 2021 to June 2022, 73 endoscopic transpapillary interventions for benign pathology and malignant pathology were performed in patients. The analysis of the frequency of the development of acute postmanipulatory pancreatitis in different time intervals in patients who underwent prophylaxis in various ways, depending on the combination of risk factors. Results and discussion: Acute postmanipulatory pancreatitis developed in 2 (3.7 %) patients who underwent transpapillary interventions in various volumes for complicated cholelithiasis. Drug prophylaxis of acute postmanipulatory pancreatitis was carried out in the preoperative period for all patients. Preventive stenting of the main pancreatic duct was performed in the presence of a combination of risk factors. Conclusion: The analysis of the results of endoscopic transpapillary interventions made it possible to identify the most significant measures that allowed to reduce the number of developed to 3 acute postmanipulatory pancreatitis to 3.7 % and thereby increase the safety of transpapillary interventions.

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Spontaneous pneumothorax associated with COVID-19-related lung damage can result in a more severe course of the disease with a high probability of lethal outcomes. A multicenter, retrospective study, which involved 1356 patients with COVID-19-induced pneumonia, was conducted. 17 patients (1,25%) developed pneumothorax. COVID-19-associated pneumothorax results in increased length of hospital stay, dictates the need for active surgical management and contributes to a higher mortality rate especially in elderly patients.