Aim. To examine the effectiveness of interstitial electrophoresis in antibacterial treatment in animals with experimental pancreatitis and in patients with acute pancreatitis. Methods. Cefotaxime concentration was studied by highly effective chromatography at different routes of administration in 40 rats of both gender with body weight of 150-250 g at the department of surgery of Kazan State Medical Academy and department of pharmacology of Kazan State Medical University. The clinical part of the research compared treatment results in group of patients (n=27) in whom interstitial electroforesis was performed together with antibacterial treatment with group of patients (n=26) who were treated conventionally. Results. Antibiotic introduction using galvanizing in experimental pancreatitis is more effective compared with traditional antibiotic introduction 24 hours after acute pancreatitis modulation. In the clinical part of the research in the main group complications were registered in 14.8% of cases, localized forms of infection (3 effusions, 1 retroperitoneal abscess) were the most common. In control group complications were seen in 34.6% of cases, generalized infections were the most common type (omental and retroperitoneal abscess - in 15.4% of cases, retroperitoneal pyogenic cellulitis - in 19.2% of cases). So, in the basic group less invasive procedures were more common compared with laparotomy, marsupialization, lumbotomy being more common in control group. Mortality rate was 11.1% in the main group and 15.4 in control group (р 0.05). Conclusion. Using interstitial electrophoresis in antibacterial treatment decreases the frequency of purulent complications, with localized forms of the infection being more prevalent, and allows to decrease the mortality rate in patients with acute destructive pancreatitis.

No abstract

The characteristic of structural subdivisions of Нашу Mondor hospital in France, the organization of its surgical service, activity indices of the hospital are given. The peculiarities of work of physicians- interns, teaching of students are described, the merits in organization of medical service to patients, the quality of diagnosis and treatment are noted.

The review decribes the radio-endovascular methods in prevention and treatment of arrosive bleedings in destructive pancreatitis. The importance of non-surgical treatment in patients with aseptic forms of destructive pancreatitis is presented. It is stressed that the problem of an optimal surgical treatment choice in patients with pancreatolysis is not solved. Efficiency of minimally invasive surgery for treating destructive pancreatitis is shown. Radio-endovascular treatment methods, including intraarterial drug infusions and pancreatic arteries embolization to prevent and treat pancreatic inflammation and arrosive bleedings from visceral arteries aneurisms, are among such options. Researches of domestic and foreign authors give the clinical basis for selective drug introduction into coeliac artery in destructive pancreatitis treatment. Clinical cases of visceral arteries (lienal, gastroduodenal, left colonic, intrahepatic) embolization are reviewed as a way of hemorrhagic complications prevention and emergency treatment in destructive pancreatitis. The problem of arrosive bleedings in destructive pancreatitis at the present stage can be adequately controlled in the conditions of specialized surgical ward equipped with operational radio-endovascular facilities and multispiral computed tomographic scanner.

Variations of homeostasis in peritonitis of appendicular origin by the indicators of vascular reactions and microcirculation are studied in dynamics early in the development. The account of the revealed variations of homeostasis makes it possible to carry out the dosed infusion therapy directed to the elimination of the functional hypovolemia in the preoperative period of preparation. For the elimination of the functional and organic insufficiency of the gastroenteric tract the endonasal intubation of the stomach and small intestine with obligatory drainage placing on the Treitz hernia and the intubation of the large intestine are necessary. The use of laparoscopic equipment with concurrent active sanation of the abdominal cavity is advisable.