Аңдатпа
Background. Clinical substantiation of applicability and safety assessment, including the identification of potential complications, of the method of regional lymphotropic administration of ceftriaxone via the transverse mesocolon as a preventive approach against infected pancreatic necrosis in acute destructive pancreatitis. Materials and Methods. A non-randomized controlled trial was conducted, including 158 patients with sterile pancreatic necrosis. The main group consisted of 79 patients who underwent laparoscopic intervention with catheterization of the mesocolon and intraoperative and postoperative lymphotropic administration of ceftriaxone. The control (historical) group included 79 patients who underwent laparoscopic intervention and received standard treatment without regional lymphotropic antibiotic prophylaxis. The primary endpoints were the feasibility and safety of the method, while the secondary endpoint was the incidence of infected pancreatic necrosis. Results. The method was successfully implemented in 65 patients (82.3). Procedure-related complications associated with mesocolon catheterization, including mesocolon hematoma and catheter displacement, were observed in 14 patients (11.4%). Intraoperative contraindications, including pronounced mesocolon edema and infiltration, were identified in 5 patients (6.3). Infected pancreatic necrosis developed in 23.1% of patients in the main group versus 44.3% in the control group (p = 0.0057), corresponding to a reduced relative risk (RR =1.53) and odds ratio (OR =2.79). Conclusion. Regional lymphotropic administration of ceftriaxone is a feasible and safe method associated with a significant reduction in infected pancreatic necrosis in acute destructive pancreatitis.