Introduction: Choledocholithiasis is present in approximately 15-20% of patients with gallstone and laparoscopic common bile duct exploration has been effectively employed many cases currently. National Center for Health Development, Mongolian Ministry of Health, registered 23180 cases of bile duct diseases which were 3.4% of total diseases, 2.5% of total surgery, 12.2% of total gastrointestinal disease, 46.9% of total liver and biliary tract diseases between 2000 and 2006. Biliary tract diseases increased 2.4 times and bile duct surgery increased 5.2 times than 15 years ago in Mongolia. To compare open choledocholithotomy and laparoscopic choledocholithotomy for common bile duct stones. Materials and Methods: This study was carried out in Mongolian national second central hospital and Inner Mongolian first medical university hospital. The clinical data of the106 patients with common bile duct stones were analyzed between Арril 2015 and Арril 2016. Duration of operation, blood loss, postoperative complication, period of hospital stay and expenditure of treatment were compared in open choledocholithotomy and laparoscopic choledocholithotomy. All patients were placed on a “T” tube drainage. Results: In results of the duration of operation (p=0.001), blood loss (p=0.001) and period of hospital (p=0.01) were significantly lower in laparoscopic choledocholithotomy group Postoperative complications and gastrointestinal function recovery time were lower in laparoscopic group whereas expenditure of treatment were lower in open choledocholithotomy. Conclusion: In conclusion main advantages of laparoscopic choledocholithotomy were reduced duration of operation, blood loss, period of hospital stay and lower postoperative complications however costly.

Introduction: Hepatocellular carcinoma(HCC) is the 6th most common cancer inthe world, but the first most commoncause of cancer death in Mongolia. Thereis no universally accepted consensuspractice guidelines for HCC owing to rapiddevelopments in new treatment modalities,the heterogeneous epidemiology and clinicalpresentation of HCC worldwide.Methods and Materials: This study wasconducted in the department of generalsurgery of Second Central Hospital ofMongolia between 2015 and 2016 on a totalof 36 patients with hepatocellular carcinoma.Results: The average of operationtime is a 132.2 min, the hospital stay 18.2days. Postoperative bleeding was 2.7% (1),encephalopathy 5.4% (2), wound infection5.4% (2), and incisional hernia 8.1% (3).There were not bile leak during 30 dayspostoperative day.Conclusion: Postoperative complicationis a comparable to different researcher.There were no death within first month.

Background: Peripheral artery occlusion is the final stage of complications in peripheral arterial disease, which has a serious negative impact on the quality of life of patients. A study conducted in Germany found that 66% of the over 40,000 patients diagnosed with peripheral artery occlusion required limb amputation within four years of diagnosis. The primary treatment goals are to improve limb blood flow, alleviate pain, accelerate tissue regeneration, and prevent cardiovascular complications. Recent studies emphasize that microsurgical techniques may accelerate tissue regeneration and improve treatment outcomes. Aim: This study aimed to evaluate and compare the effects of end-to-end (ETE) and end-to-side (ETS) microvascular anastomosis in a rat model of ischemia, focusing on tissue regeneration. Materials and Methods: Thirty Wistar rats were divided into two groups (control group 10 rats, ischemic group 20 rats) at the Bio-Medical Research Institute of the Mongolian National University of Medical Sciences. Ischemia was induced in the experimental group, and ETE and ETS anastomoses were performed using donor arteries, which were preserved for three days. Preoperative and 21-day postoperative body weight, artery size, and blood flow were measured and analyzed to determine the results. Results: In the control group, the average body weight was 227.86±21.11 grams before surgery, which increased by 12.38 grams to 240.24±25.77 grams post-surgery (p<0.01). In the ischemic group, the rats that underwent ETE anastomosis had an average weight of 239.67±26.96 grams before surgery, which decreased to 234.3±27.20 grams immediately after surgery, but increased to 250.67±27.09 grams after 21 days (p<0.05). The ETS group showed an increase from 235.18±22.39 grams to 249.62±21.12 grams after 21 days (p<0.01). The surgical duration for the control group was 24.51±2.29 minutes, while the ischemic group required 39.75±0.89 minutes for ETE and 46.65±8.12 minutes for ETS anastomoses (p=0.001). Intraoperative blood loss in the control group was 0.27±0.12 ml, whereas the ischemic group showed blood loss of 0.58±0.13 ml for ETE and 1.12±0.61 ml for ETS, with some instances reaching 2.35 ml (p<0.01). Conclusions 1. The body weight of the control rats increased to 240.24±25.77 grams after 21 days, while the ischemic group showed an increase to 250.67±27.09 grams, indicating improved tissue regeneration and successful microsurgical anastomosis. 2. Although PCNA and KGF protein expression levels decreased, tissue regeneration was robust, as evidenced by the continued regeneration observed 21 days after the microsurgery, indicating successful microvascular surgery. Differences in the response to ischemic changes were observed across tissues, with increased expression of KGF and PCNA in the skin and muscle tissues, further supporting the effectiveness of the regenerative process.

Background: Treatment of adult tibiofibular fractures, especially severely comminuted fractures, is technically challenging due to the lack of reduction markers and difficulty in restoring the alignment. Fixation of the fibula can facilitate reduction of the tibia fracture and restoration of the lower extremity alignment. Methods: Between 2018-2019 we have operated on 50 patients who have lie on the same plane of tibiafibular fractures. Measures of angulation were obtained from radiographs taken immediately after the surgery, a second time 3 months later, and at 3-month follow-up. The analysis was performed with STATA. Results: Fixating fractures of tibia and fibula at same level were not shown to have complications on the development of nonunion including fibular shortening, hindfoot alignment, slow process of nonunion and unstableness. Conclusions We recommend fibular fixation in all 50 distal fractures when both fractures lie on the same plane and the tibial fracture is relatively stabilized.