Objective. To study up the possibilities of improvement of the treatment results in patients, suffering an acute pancreatitis, using the method of delivery of antibiotic to pancreatic gland. Materials and methods. The authors have proposed and conducted the experimental investigation on 20 male rats, consisting of the manners to deliver of ceftriaxone towards pancreatic gland. Results. Taking into account the enhances antibacterial efficacy of pancreatic gland homogenate, than while antibiotic delivery using other methods, there appear that lymphotropic therapy owes a targeted character and must be considered a perspective one. Conclusion. To three groups of laboratory animals ceftriaxone was prescribed intramuscularly, intraperitoneally and in accordance to lymphotropic method. To the control group of laboratory animals, the fourth one, antibiotic, was not applied. The zone growth retardation for E. Coli, while application of lymphotropic method, comparing with intramuscular and intraperitoneal methods of the preparation delivery, was enhanced.

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.

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Objective. To investigate the impact of the sorbtion-aspiration drainage system on background of hydroxyapatite and zinc oxide on experimental peritonitis. Materials and methods. The experiment was performed on 55 white laboratory rat males, ageing 2 - 3 mo, with the body mass 225 - 250 g, which were kept in the typical vivarium conditions. Suspension of E. coli in physiological solution, 1.0 - 1.5 ml in concentration 1010 , was used for the peritoneum contamination. The suspension was introduced into abdominal cavity in the dose, dependent on the animal body mass, using the syringe for insulin injection. Peritonitis in the rats was developed in 48 h and characterized by intoxication, which exaggerated rapidly, as well as by intestinal motor disorders and pronounced microcirculatory disturbances. The experimental animals were distributed into 5 Groups. In patients of Group I the interventions were not performed (control); in laboratory animals of Group II peritonitis was not simulated, but the abdominal cavity was drained, using the sorption-aspiration drainage system; in laboratory animals of Group III peritonitis was simulated; in the Group IV of laboratory animals on background of peritonitis the abdominal cavity was drained, using the sorption-aspiration drainage system; in the Group V animals the abdominal cavity was drained by a standard silicon drain on background of peritonitis. Results. Reduction of abdominal contamination by 43.12% and of histological features were produced in abdominal organs under the influence of the composite system, witnessing its bactericidal and sorption-antiinflammatory action. Conclusion. Experimentally there was confirmed the possibility of application of sorption-aspiration drainage system on background of hydroxyapatite and zinc oxide in treatment of an acute peritonitis.

Objective. To study the peculiarities of antibiotics accumulation in appendix vermiformis after various methods of their introduction. Materials and methods. The investigation was conducted in 160 patients, to whom antibiotic was introduced by various methods: 53 – intramuscularly; 52 – intravenously; 55 – lymphotropically. In part of the patients the antibiotic was introduced at 1 h preoperatively, and to the rest – at 2 h. After performance of appendectomy from each third part of the appendix vermiformis (proximal, middle and distal) excised a homogenate was made, which was sowed into Petri dish on the laboratory culture of E. coli. In a day there were stunting growth zones registered in this laboratory culture in millimeters, and in accordance to their dimensions the level of the antibiotic accumulation was determined. Results. After intramuscular introduction the antibacterial preparation in tissues of appendix vermiformis did not accumulate. After intravenous introduction of ceftriaxone at 1 h preoperatively it have accumulated in 65.4% patients in proximal and middle thirds of appendix vermiformis, in 34.6% patients in the appendix vermiformis apex the antibiotic accumulation was not observed. After the antibiotic introduction 2 h preoperatively its concentration have diminished in two times. After lymphotropic introduction the antibiotic have accumulated in all parts of appendix vermiformis, and in 2 h its quantity have enhanced significantly. Conclusion. Accumulation of antibiotic in the appendix vermiformis after it intravenous introduction have rapidly reduced, and after a lymphotropic one – enhanced, witnessing the advantage of lymphotropic method, which must become the alternative one in appendicitis, due to its targeticity and property for accumulation.