Complete laparoscopic anterior approach to peripancreatic abscess drainage for severe acute pancreatitis has always been a difficult problem in clinical treatment, with patients in critical condition, prolonged disease duration, huge medical expenses and unstable treatment effect. In the second department of hepatobiliary surgery, a patient with cholestatic pancreatitis transferred from Laiwu was treated with ERCP+ENBD lithotripsy and improved. During the recovery period, the patient’s condition recurred, blood amylase and lipase increased again, gastrointestinal decompression and drainage fluid increased, abdominal distension, fever, intolerance of enteral nutrition, Chinese medicine enema could not effectively control body temperature, CT showed abdominal ascites, small omental sac irregular fluid area with separation and formation of pseudo Cyst, calcitoninogen 9.13ng/dl, white blood cell count 15.28~10^9/L, neutrophils 0.887%. The patient’s blood culture was positive for Enterobacter cloacae, and he had been using antibiotics for a long time and was facing dysbiosis. Faced with the patient’s complex condition, Tian Hu of the Department of Hepatobiliary Surgery of Shandong Qianfo Mountain Hospital, after a department-wide case discussion, explained the condition and prognostic possibilities to the patient’s family in detail, and performed surgical treatment for the patient to fully drain the retroperitoneal fluid on the basis of gaining full understanding from the patient’s family. In order to reduce trauma, it was decided to perform a complete laparoscopic anterior approach for peripancreatic abscess drainage. The operation was performed by Dr. Tian Hu, the chief surgeon. For safety reasons, the operation was performed by using a layer-by-layer incision to establish an artificial pneumoperitoneum, exploring the abdominal cavity with a large amount of inflammatory exudate and severe edema and saponification of tissues. After aspiration of the abdominal exudate, the ultrasonic knife was used to carefully dissect and avoid damage to the gastrointestinal tract, and a pseudocystic access was successfully searched for to remove the large amount of pus present in the cyst, and multiple drains were placed after adequate opening. The surgical treatment of severe acute pancreatitis is mainly pancreatic and surrounding necrotic tissue removal and peripancreatic drainage, which is traditionally done by open surgery with multiple drains, which is more traumatic and has poor incision healing. The success of this case of posterior laparoscopic access surgery for severe pancreatitis has been carried out in our department, which enriches the surgical treatment of severe acute pancreatitis and is especially suitable for patients with pancreatic head and neck location, predominantly exudate and less necrotic material. The disadvantages of open surgery were avoided, benefiting the patient.