NEW POSSIBILITIES OF ANTIBIOTIC THERAPY IN THE TREATMENT AND PREVENTION OF I NFECTED ACUTE PANCREATITIS

Abstract

Summary. Introduction. One of the most difficult problems in surgery today is the treatment of acute pancreatitis, which remains the third most frequent acute surgical disease. The frequency of the latter is growing every year. Despite the achievements of pharmacotherapy and infusion therapy, mortality in acute pancreatitis remains at the level of 15–45 %, and in the development of purulent complications it reaches 70–80 %.
 The urgency of the problem. The use of antibiotics for complicated pancreatic necrosis is obvious, but antibiotic therapy does not always lead to the desired result. Given this, the attitudes of surgeons to the use of antibiotics do not coincide, especially when it comes to their preventive use. The above determines the urgency of the problem.
 Purpose of work. To study the possibilities of new ways of supplying antibiotics to the pancreas in its acute inflammation.
 Materials and methods. We have studied the immediate results of the use of antibiotics in acute pancreatitis in the conditions of their introduction by the lymphotropic route. The examination of patients was performed according to generally accepted methods, including ultrasound at admission and on the 4th day of treatment.
 Results and discussion. During the first 4 days of treatment, the patient’s condition almost normalized: the pain in the first day was localized in the epigastrium, changing from cutting and «tearing» to dull; weakness, dry mouth disappeared and the temperature returned to normal. The number of leukocytes decreased from (10,5 ± 3,8)×109/l to (6,6 ± 2,4) × 109/l. The leukocyte index of intoxication according to Calf-Calif decreased by (2,63 ± 0,7) cu, ESR – normalized, the amount of blood amylase decreased on average from 500 cu. up to 50 cu. This was due to a decrease in the volume of the pancreas in the head, body, cauda by 6,4 – 3,9 – 7,0 mm, respectively.
 Conclusions. The lymphotropic route of administration of antibiotics to the inflamed pancreas contributed to its reduction, which was accompanied by an improvement in the indicators of the inflammatory process according to Calf-Caliph, a decrease in the number of leukocytes and ESR, reduced gland volume and elimination of pain and other signs of the disease by the 4th day.