Only a few studies have investigated the complications of laparoscopic cholecystectomy in children. Therefore, relevant case reports will be of interest to pediatric surgeons. The patient was a 10-month-old boy diagnosed with calculous cholecystitis who underwent laparoscopic cholecystectomy. He had peripheral edema and adhesions in the neck of the gallbladder. After 10 h, a clinical picture of intra-abdominal bleeding developed. During relaparoscopy in the area of the gallbladder bed, arterial bleeding from the liver vessel was noted, which was eliminated by coagulation. The postoperative period was uneventful, and the child was discharged on day 8. In the second case, a 10-year-old girl was admitted for chronic calculous cholecystitis, and laparoscopic cholecystectomy was performed, in which a pronounced adhesion process was noted in the gallbladder neck region. On day 8, the child was discharged home; however, after 26 days, the patient was admitted again, with a clinical picture of diffuse biliary peritonitis. During laparoscopy, bile outflow from the gallbladder bed was noted, which only partially eliminated by monopolar electrocoagulation. Drainages were installed, through which bile began to be abundantly secreted in the postoperative period. Laparoscopy with a transition to open surgery was performed, during which a perforation in the wall of the common bile duct was found, and stenting and suturing of the defect were performed. In the postoperative period, active infusional infusion and antibacterial therapy were given. The patient was discharged on day 29. Postoperative complications of the ClavienDindo type IIIb are associated both with the presence of congenital anatomical features and inflammatory-adhesive changes in the Calo triangle zone and with the possibility of latent lesions during monopolar coagulation in both cases. The evaluation of the tactics of eliminating biliary peritonitis in the second patient emphasized the necessity to switch to open laparotomy during the second operation. These cases indicate the need to comply with the principles of safe laparoscopic cholecystectomy, including the availability of modern endoscopic equipment and the experience of surgeons in endosurgery. This requires the concentration of patients with cholelithiasis in specialized clinics.

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Introduction. Cryptorchidism is a common disease in pediatric urological and andrological practice since the issues of tactical approaches and its optimal treatment remain extremely relevant. Cryptorchidism makes a significant contribution to the structure of male infertility.Objective. To conduct a retrospective analysis of treatment results in children and adolescents with cryptorchidism.Materials & methods. This study summarises the treatment results of 8308 patients with cryptorchidism aged from 6 months to 17 years who underwent inpatient treatment in the Russian Federation and the Republic of Uzbekistan.Results. It was revealed that from 2015 to 2019, patients were admitted for surgical treatment evenly over the years. The ratio of right-sided / left-sided / bilateral cryptorchidism was 4.6 : 4.4 : 1 The inguinal form prevailed more than 6 times over the abdominal location. At the same time, 26.1% of the patients underwent surgery at the optimal time, and 9.8% were older than 10 years. More often, children are operated from an open inguinal access (95.0%), much less often — laparoscopically and percutaneously. Stage-by-stage treatment was carried out in 6.0% of patients.Conclusion. Thus, the approach presented in the study in the surgical treatment of cryptorchidism provided good treatment results. The number of disease relapses was 1.9% (mainly among children over 7 years old). Most surgeons are very reserved about primary orchidectomies (only 3.8% were performed).

Introduction. Gastric perforation in newborns is a polyetiological, severe disease that combines a number of destructive conditions, such as: isolated pinpoint perforations, wall necrosis and gastric rupture. The first description of this pathology in a premature infant was made by Siebold in 1825, and only in 1968, G. Reams reported a case of successful diagnosis and surgical correction of this disease. Currently, the frequency of gastric perforation occurs from 1 to 6 cases per 30 thousand live births, and the mortality rate is within 40–70%.In all infants, disorders in the integrity of stomach wall can be divided into iatrogenic and “idiopathic” which are caused, in most cases, by intrauterine hypoxia. Therefore, while examining such patients, differential diagnostics between gastric perforation and necrotizing enterocolitis is often made.Clinical case. The authors present their experience in diagnosing and treating segmental necrosis of the stomach and duodenum outlet in a child with an extremely low body weight of 800 gr. Predisposing factors in the antenatal period were considered to be manifestations of hereditary thrombophilia, severe preeclampsia, placental insufficiency, and intrauterine growth retardation. As far as the discussed pathology had a subacute course, clinical changes were registered only on the 21st day of infant’s life, when pneumoperitoneum was detected at the plain X-ray image. When the patient’s condition was stabilized, median laparotomy was performed, at which radial necrosis with detachment in the gastroduodenal junction was seen. An end-to-end gastroduodenoanastomosis was put at the defect zone. In the postoperative period, the course was complicated with bronchopulmonary dysplasia, oblique femoral fracture with angular fragment displacement because of premature osteopenia as well as cholestatic hepatitis. The patient was discharged from the hospital in satisfactory condition in 80 days.Conclusions. Thus, better understanding of specific features in the clinical picture of the discussed pathology and of the mechanisms of perforation development in hollow organs of the abdominal cavity will reduce the number of complications and adverse outcomes in patients with extremely low body weight.