[Choice of time and mode of operation in severe acute pancreatitis]

We report the treatment of 75 patients of severe acute pancreatitis. Operations were performed on patients with pancreatic infection and organ failure according to the principle of "individualization". Operation was also indicated for the patients aged 60 who had had no improvement after a short period of non-operative treatment because of the susceptibility to develop MOF, Non-operative treatment was administered to other patients. This therapeutic mode can increase the cure rate while complications can be decreased. Early operation is necessary for patients with single organ failure in case sequential MOF might happen. The main components of operation were elimination of necrostic lesion, lysis of the pancreas, multiple drainage, and adequate postoperative peritoneal lavage. This operation can not only eliminate necrostic tissue, but also prevent progressive pancreatic necrosis. It introduces free drainage, and can bring satisfactory therapeutic result and reduce the possibility of reoperation.