Relevance of the topic. Acute pancreatitis (OP) is originally an aseptic inflammation of the pancreas, with possible damage to the surrounding tissues and individual organs, as well as systems, which is the third most common after acute appendicitis and acute cholecystitis in the number of patients. In this regard, an experimental model is needed to further determine the tactics of management and treatment of patients with acute pancreatitis of varying severity. Objective: to develop a universal model of acute pancreatitis with the ability to control the area of ​​pancreatic necrosis through the use of various overlays (distal or proximal to the confluence of the accessory pancreatic duct into the common bile duct) of the ligature, which will ensure the development of total or subtotal pancreatonecrosis. Materials and methods. Matured white Wistar rats weighing 250-300 g were chosen as objects for the study. The simulation of acute pancreatitis in the experiment was carried out using a 50% bile solution (pH = 6.0) followed by intraductal injection without cannulation of the major duodenal papilla. To control the degree of severity and area of ​​the pancreas lesion, we use the staged overlay of turnstiles at the confluence of the additional pancreatic ducts and the common bile duct, which ensures the development of acute pancreatitis of varying severity. On the 5th day, the rats were removed from the experiment, an autopsy was performed with the removal of pancreatic preparations for further histological examination. The evaluation of the immune and oxidative parameters of the blood of experimental animals. Statistical processing of the obtained results was performed using descriptive and variation statistics techniques. Results. In the course of this work, moderate and severe acute pancreatitis is modeled, which allows us to focus on the course of each subject to variation statistics, determining their reliability, which is an important condition for creating the necessary platform for further study of the management and treatment of this disease. Findings. I use the resulting model, we managed: - to obtain a high reliable result of operations with minimal death of experimental animals, i.e. high repeatability of positive results; - perform an accessible operation with obvious technical simplicity; - see the possibility of a simulated disease for a long time up to 5 or more days, which subsequently allows medical intervention and testing of new dosage forms and drugs for treatment and studying their effects. Thus, it is possible to judge the universality of this model of acute pancreatitis under experimental conditions.

The ratio of the prevalence of the gallstone disease (GSD) in the elderly and senile age groups compared with young and middle-aged patients can reach 3:4. The main complication of the GSD is acute cholecystitis, which is observed in more than 90% of patients. However, the most dangerous complication is considered to be obstructive choledocholithiasis, which leads to the development of mechanical jaundice and cholangitis in 10 - 35% of cases. The aim of the researchwas to propose an algorithm for the treatment of the GSD complicated by acute cholecystitis and obstructive choledocholithiasis in elderly and senile patients with severe concomitant pathology. Methods.The study is based on the analysis of the results of examination and treatment of 47 patients with GSD complicated by acute calculous cholecystitis and obstructive choledocholithiasis. All patients were divided into 3 groups. The first group included 17 patients in whom, in addition to acute cholecystitis, choledocholithiasis with concretion infringement in the BSDK was detected. The second group included 24 patients in whom, in addition to acute cholecystitis, obstructive choledocholithiasis and cholangitis were diagnosed. The third group included 6 patients in whom for some reason choledocholithiasis was not diagnosed at the first stage or it occurred later as a complication of cholecystostomy. Results.For patients of the first group the endoscopic papillosphincterotomy on stone was performed followed by cholangiography to find out the status of the bile ducts. Patients of the second underwent percutaneous transhepatic choledochostomy at the first stage. Patients of the third group were injected a Foley catheter into the cavity of the gallbladder through the cholecystostomy opening and the cavity of the gallbladder was sealed. Saline solution was injected into the lumen of the gallbladder and its ducts under the pressure of 250 mm. aq. art. This led to the dilatation of the lumen of the bile ducts. Conclusions.The proposed algorithm allows radical treatment of the GSD complicated by choledocholithiasis and cholangitis. The differentiated approach to the transpapillary solution of choledocholithiasis allows to minimize the risk of post-manipulation pancreatitis. AAPST allows to cure choledocholithiasis when endoscopic papillosphincterotomy is dangerous or not feasible.

Importance. Functional results of treatment of the ventral hernias of the medial localization after endoprosthetics of the abdominal wall by the standard polypropylene prosthesis remain unsatisfactory because of the limited flexibility of the abdominal wall. Purpose. To improve functional results of treatment of patients with ventral hernias of the medial localization by applying a light strengthened endoprosthesis. Materials and methods. There was done a comparative analysis of the results of treatment of 60 patients with medial hernias of the anterior abdominal wall. Patients were divided into two groups with 30 people in each group. In the first group over-aponeurotic endoprosthetics of the abdominal wall defect was provided with the use of a standard polypropylene prosthesis with the thread diameter 120 micron, while in the second group there was used a light strengthened endoprosthesis with the thread diameter in the basic zones 90 micron and in the strengthened zones 120 and 90 micron. Effectiveness of treatment in the nearest post-operative period was evaluated by the degree of severity of inflammatory implantation response, and in the long-term period evaluation was done on the base of functional state of the abdominal muscles, quality of life of patients and results of treatment by four point scale. Results and their discussion. Inflammatory exudative response on implantation of the light strengthened endoprosthesis was less and reparative response was 1,1 times higher compare to a standard prosthesis. Endoprosthetics of the abdominal wall with a light strengthened endoprosthesis improved contractility of the abdominal muscles in 1,2 times. Restoration of the functions of the abdominal muscles had a positive influence on quality of life, namely, physical component of health improved by 4,5%, as well as on long-term results of treatment by the increased number of excellent and good results of treatment by 20% and reduction of satisfactory results by 20%. Conclusions. The use of a light strengthened endoprosthesis enables to improve the functional results of treatment of ventral hernias of the medial localization.