A continuous increasing of the acute pancreatitis incidence, especially its severe forms, including destructive purulent diseases of the pancreas, is observed in recent years (V. V. Vashchuk, V. P. Andryushchenko, 2020). In the structure of the abdominal cavity urgent diseases, acute pancreatitis accounts for 7–14 % (V.P. Andryushchenko, 2010; O.I. Dronov, 2008). The pathogenesis of acute pancreatitis is very complex, which gives reasons for different attitudes towards the disease. Since infectious complications remain the leading factor in the dynamics of acute pancreatitis, most authors prescribe antibacterial agents for treatment of acute pancreatitis. However, opinions about the term of their application are different.
An experimental study was conducted by us with mature males of the Chinchilla breed. Antibacterial medicines (ceftriaxone) were administered using loco regionally lymphotropic method in combination with pathogenic agents and lymphostimulating medicines.The inhibitory effect of the medicines 1 hour after administration was at the level of 70 % of the pure medicine action, and after 2 hours its effect increased to 90 %. In our previous study after intravenous administration, the medicine was detected in the vermiform process at 70% of the control dose, and after 2 hours its amount dropped to subclinical levels. With the consent of the patients, acute pancreatitis was treated in 83 patients of the main group. The comparison group consisted of 85 people, not significantly different in quantitative terms (p>0,05), which became the basis for comparing the obtained results. Increasing of all parts of the pancreas was established by ultrasound in patients of the main group and the comparison group, which is explained by its swelling. However, under the influence of lymphotropic therapy, the reduction was so significant that the pain syndrome almost disappeared on the second day, while it lasted up to 4– 5 days in patients of the comparison group. The volume of the spleen in patients of the main group decreased to the normal size, while in the comparison group decreasing was very insignificant. With delayed hospitalization, the leukocyte intoxication index (LII) in patients of the main group decreased almost to the normal indicator, and in patients of the comparison group, it underwent very minor changes. MOD LII and GII in patients of the main group decreased significantly, while in patients of the comparison group - insignificantly. The total number of leukocytes decreased by 7,2x109 /l, and the patients of the comparison group by 2.9x109 /l (p<0.001), which is 2,5 times more in favor of lymphotropic therapy. 53,1% and 71,1% reduction in SZE in the first and second subgroups of the main group compared to a slight decrease in the comparison group (15,8% and 14,3%), respectively, in the first and second subgroups, indicating a predominant effect of lymphotropic therapy on the immune status of patients with acute pancreatitis. The level of CD–3 and CD–4 increased under the influence of lymphotropic therapy, and the level of CD–8 decreased. The effect on these indicators in patients of the comparison group was much smaller and, accordingly, unreliable. A similar effect of lymphotropic therapy occurred on VLG. The reduction of CRP data under the influence of lymphotropic therapy was greater by 5,3 times (p<0,001), and the level of amylase decreased up to 60 %, while under the influence of standard antibacterial therapy - up to 30 %. Along with the effect of lymphotropic therapy on immune parameters, there was decreasing of the pancreatic gland volume, to 8,0 mm – 10,0 mm and 7,8 mm (head, body and tail, respectively), while the effect of standard antibacterial therapy was much smaller. The reduction of these gland sizes detected the positive course of the process (reduction of pain syndrome, radiation of pain, flatulence) earlier and more effectively than with standard antibacterial therapy. Among patients of the comparison group, surgical intervention was performed in 11 (12,9%) persons with a fatal in 2 (2,4%) 2 (2,4%) patients from this group also died without surgery. Totally 4 (4,8%) patients in the comparison group died. Therefore, the effect of lymphotropic antibacterial therapy on the course of inflammation of the pancreas and parapancreatic tissue, the effect on the immune system and its organs, the prevention from progression and the effect on the operative and postoperative periods are objective evidence of the positive alternative of lymphotropic antibacterial therapy according to the standard one in the treatment of acute pancreatitis.
