BACKGROUND:Acute inflamed process in gallbladder stand no more in the list of contraindication for its laparoscopicremoval, although specifity of operational technics need to be elaborated in details.PURPOSE:The purpose of the study to determine feasibility and specifity of laparoscopic cholecystectomy.METHODS AND MATERIALS:Based on standard instructions three holes were punched on the front wall of the abdominal cavity forinsertion of fibroscopic instrument, Olympus-2008, Model-Uni 3, input-120/240V, 50/60Hz, 150VA. Patientselection included 108 individuals hospitalized during 2009-2013 in the department of urgent surgery, IIIShastin Clinical Hospital.RESULTS:Average ages of the patients were 38. Clinical diagnosis based on signs and symptoms revealed at thephysical examination confirmed by echosonographic investigation for final diagnosis. Specificity of surgicaltechnics were incision and infusion of large amount of antibiotic solution into the inflamed gallbladder at theinoculation; use blunt edge for inoculation of the duct and artery of gallbladder; switching to open surgeryin case of revealed massive enzymatic infiltration and adhesive scars.CONCLUSION: Laparoscopic cholecystoectomy is feasibility operative procedure having advantages anddisadvantages, requiring necessary preventive measures of the complications.

Introduction: About 20-30% of patients with acute pancreatitis have a severe disease and mortality rate among inpatients were 15%. There are many causes of acute pancreatitis (AP), but most common cause of AP is an alcohol. According to some studies in our country, alcohol is the number one cause of acute pancreatitis and the mortality rate is 15.3%. Very important for prognosis of disease optimal choice of treatment tactics, detection of infectious evidence of necrotizing pancreatitis. Therefore, based on the above, there is an urgent need to conduct research to address important issues and to improve the diagnosis and treatment of acute alcohol-induced pancreatic necrosis. Goal: Determine the importance of early diagnostic assessment of alcohol induced severe acute necrotizing pancreatitis. Materials and Methods: Research model and research method. We conducted our research using an observational research model and a factual research method.Sampling of research materials will be carried out by targeted sampling. From November 1, 2008 to January 1, 2020, 122 patients who were hospitalized with alcohol-inducedAP were selected and archival documents or medical histories were selected. Statistical analysis was performed using averages and regression analysis methods to calculate the laboratory parameters in the analysis related to the new evaluation system. Results: The minimum age of patients with ANP was 25 and the maximum was 71, with the majority (87.4%) aged 26 to 60 years. When the Person Correlation method calculates the relationship between alcohol consumption and mortality, it is assumed that the weaker the correlation, the higher the amount of alcohol consumed, the lower the cure and the higher the mortality. Of the 31 deaths reported in the study, 24 (77.4%) were hospitalized more than 72 hours after the onset of the disease. Late hospitalization and late treatment of patients with acute necrotizing pancreatitis (ANP) disease have been shown to adversely affect the prognosis of the disease. In our study, all parameters were significant, but procalcitonin, serum amylase, serum lipase, serum LDG8 C-reactive protein, serum glucose was found to be higher than the value specified in the evaluation system for the variable (in determining pancreatic necrosis). АNOVA analysis test showed that white blood cells, procalcitonin, serum amilza, serum lipaza, serumglucose, serum LDG, C-reactive protein were higher than those specified in the evaluation system, and that the level of significance for the variable (indicating a severe pancreatitis or poor prognosis) was higher than other test results (P <0.01). According to the new evaluation system, 12 out of 122 patients were classified as A class or 0-3, 69 (56.5%) patients were class B or 4-6, and 41 (33.6%) patients were class C or >7 points. Of the total cases, 90.1% were rated as severe form of ANP and pancreatic necrosis by the classification system we developed. When we assessed the prognosis with the new assessment system, we found that 100 percent of patients in category A were cured, 89.8 percent of patients in category B were cured, and 41.5 percent of patients in category C were cured and 58.5 percent died. Statistical calculations using the correlation analysis method for the correlation between the score and the cure of the evaluation system shows negative correlation (P <0.01) other words, the higher the score of the evaluation system, the lower the cure rate and the higher the mortality rate. Conclusion In Mongolia, relatively young men suffer from alcohol-induced pancreatitis.Factors contributing to the development of necrosis in acute pancreatitis include alcohol abuse, prolonged alcohol use, delayed hospitalization, and delayed treatment.In our study, following clinical signs and laboratory findings are effective in distinguishing severe forms of acute necrotizing pancreatitis, early diagnosis, assessment of prognosis. Laboratorytests include: increase in white blood cells, procalcitonin, serum amylase, serum LDH, serum lipase, C-reactive protein and a decrease in hematocrit, serum calcium.

We describe a minimally invasive endovascular approach to treat an arteriovenous fistula of the scalp. We performed a direct puncture of the lesion through the patient’s scalp for liquid embolic agent injection along with external compression of the superficial temporal artery to perform a “manual pressure-cooker technique.” The combination of these minimally invasive techniques resulted in an excellent clinical and radiographic outcome.

Background: During inversion injuries of the ankle joint, the anterior talofibular ligament (ATFL) is the most commonly injured structure. Injuries to the lateral collateral ligaments of the ankle, either in isolation or in combination with injury to the calcaneofibular ligament (CFL), account for approximately 60-65% of all ankle ligament injuries. In recent years, several studies have examined the impact of lateral ankle ligament injuries on lifestyle and overall health. Repeated inver sion injuries-particularly those occurring three or more times-can lead to chronic ankle instability (CAI). In the treatment of ankle instability, both open and arthroscopic surgical techniques are widely used internationally. In Mongolia, there is an increasing clinical need to evaluate and compare the outcomes of arthroscopic versus open surgical repair of lateral ankle ligament injuries. This need forms the basis of the current study. Aim: The comparative studies on open vs arthroscopic anterior talofibular ligament (ATFL) repair are limited. This study aimed to compare the early therapeutic efficacy and cost between the traditional open Broström-Gould repair and all-ar throscopic anatomical repair of the ATFL for chronic lateral ankle instability. Materials and Methods: A total of 40 patients with chronic lateral ankle instability undergoing repair of the ATFL be tween September 2024 and February 2025 were retrospectively included with a traditional open surgery (n=10) group and an arthroscopy (n=17) group. The surgery duration, surgical cost, postoperative complications, and the preoperative/ postoperative American Orthopaedic Foot & Ankle Society Score (AOFAS) and Karlsson-Peterson score were compared between groups. Results: Compared to the anatomical group, the non-anatomical group had significantly shorter surgery and hospitaliza tion durations. Three months after the operation, the AOFAS and Karlsson scores significantly improved in both groups. Nevertheless, there was no significant difference in the AOFAS and Karlsson scores between groups at both preoperative and postoperative assessments. No significant difference was found in the incidence of postoperative complications be tween the two groups. Conclusion 1. These results suggest that open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL have comparable therapeutic efficacy for chronic lateral ankle instability. 2. The arthroscopic surgery had a smaller incision, while the open Broström-Gould had a shorter surgery duration and lower cost.