ABSTRACT
Objective To introduce the current status of treatment of severe acute pancreatitis (SAP). Methods This summarization paper of SAP was made on literature review. Results During the stage of acute reaction , therapy should be emphasized on non surgical management, such as maintaining the homodynamics ; inhibiting the overexpress of cytokines and pancreatic secretion; administering antibiotics preventively, TPN and improving the function of other damaged organs.The operation timing should be delayed if possible.Thus it could increas the cure rate, decrease complications and the possibility of reopeneration. But in the case of SAP with biliary obstruction, secondary infection with necrosis of pancreas; failure to respond to initial intensive treatment and clinical diagnostic was uncertain, early surgery should be performed. The operation should be easy to be done, ensuring enough drainage, and resolving the obstruction of biliary tract. During the septic stage, besides administerded antibiotics and EN, surgery is primary therapeutic method: necrosectomy and continuous closed lavage were considered as a better treatment of infected necrosis focus, while pancreatic absecess should be drained operatively. During the last stage of residual infection, abdominal abscesses should be drained thoroughly. Conculsions According to the etiology and stage of SAP, comprehesive management guided by "individualized plan"is probably a better strategy of treatment of SAP.
