Surgical therapy of severe acute pancreatitis (SAP) has been developed through several stages.The initial active surgery was replaced by conservative treatment followed by selective surgical intervention.Surgical procedures changed from pancreatic capsule incision and pancreatectomy at the early stage to necrosectomy at the later stage.Recently,planned minimally invasive necrosectomy was used to treat SAP patients.Some patients received ultrasound or CT guided drainage initially were finally cured by definitive open necrosectomy.In recent years,more advanced management of SAP developed in multidisiplinary treatment.Therefore,comprehensive treatment of SAP including the indication of surgical intervention at early stage and the optimal timing and the rational method of surgery at the late stage of SAP was discussed.

作者：王春友

来源：中华消化外科杂志 2012 年 11卷 4期