Nitric oxide in the complex treatment and prevention of complications for acute pancreatitis

Rationale: The high level of mortality, the lack of a unified treatment strategy encourage surgeons to search for the most optimal options for the prevention and treatment of patients with acute pancreatitis. There are no works in the literature on the use of exogenous nitric oxide in the complex treatment of patients with acute pancreatitis. Purpose: to study the effect of nitric oxide on the inflammatory process in the pancreas. Materials and methods. 20 patients with acute pancreatitis (main group) were examined and treated. Patients of the main group received additionally against the background of complex treatment insufflation of nitric oxide through a nasogastric tube into the stomach from the Plazon apparatus. The comparison group included 15 patients who received traditional therapy. Results: The groups were comparable in terms of gender, age, degree of pancreatic damage. On the basis of a comprehensive examination, mild acute pancreatitis was diagnosed in 4 patients, moderate in 6, and severe in 10 patients. After 2 days from the start of NO-therapy in all patients, abdominal pain stopped, the temperature returned to normal. On the 8th day from the start of NO-therapy, the total number of blood leukocytes decreased by 1.6 times, the content of lymphocytes increased by 3.4 times, the ESR decreased by 2.6 times. There was an increase in the population of T-helpers by 40.3%, a decrease in T-suppressors by 20.2%, IRI was 1.05, which characterized a decrease in the tension of pancreatic ischemia. The concentration of immunoglobulin G decreased by 9.2%, the concentration of immunoglobulins A and M increased by 13.4% and 12.5%, respectively (to normal values). Conclusion: In the complex treatment of patients with OP, nitric oxide has an immunocorrective effect, stabilizing local immune responses, and reduces T-immunodeficiency. Against the background of exogenous nitric oxide therapy, humoral immunity is activated, the membrane component of damaged cells is restored, and microcirculation improves. In all patients, recovery occurred 2 times faster than in patients who were not included in the complex treatment of NO-therapy.