The 2002 International Pancreatic Federation guideline recommendations for the surgical treatment of acute pancreatitis, regarding the principles of surgical treatment include: 1. mild pancreatitis is not an indication for surgical treatment; 2. fine needle aspiration plus bacteriological testing in patients with signs of infection to distinguish between aseptic and infected necrosis; 3. infected pancreatic necrosis with signs and symptoms of infection is an indication for surgical treatment and radiological interventional drainage; 4. Recommendation 5: Patients with aseptic pancreatic necrosis (FNAB-negative) should be treated conservatively and surgically only in some special cases; 5. Unless there are specific indications, early surgery is not recommended for patients with necrotizing pancreatitis within 14 days after the onset of the disease; 6. 7. cholecystectomy should be performed to prevent recurrence of biliary pancreatitis; 8. patients with mild biliary pancreatitis should undergo cholecystectomy as soon as they recover, preferably during the same hospitalization; 9. patients with heavy pancreatitis should undergo cholecystectomy after the inflammation is well controlled and the patient recovers; 10. patients with biliary pancreatitis who are not suitable for surgical removal of the gallbladder can undergo endoscopic duodenal The recurrence can be prevented by endoscopic duodenal myotomy. Which patients with severe acute pancreatitis need to consider early surgical treatment? There is a general consensus that surgical treatment of SAP within 14 days is not advocated, and that postponement of surgery is necessary to allow for differentiation of the pancreas and peripancreatic necrotic tissue. It is generally considered that 3-4 weeks after onset is the best time for necrotic tissue debridement, which is less extensive and conducive to invasive surgery, and allows for minimal resection to avoid excessive tissue removal leading to postoperative endocrine and exocrine pancreatic dysfunction. However, early surgical treatment must still be considered in the following cases: 1. Acute extra heavy pancreatitis manifests itself as rapid development of multi-organ failure within days of onset, and the morbidity and mortality rate remains extremely high. For these patients, if they are treated in the ICU and still have successive organ dysfunction or deterioration, surgical treatment may be attempted to reduce pressure and drainage, which may increase the hope of survival. These cases often develop rapidly, and the time available for surgery is often very short. Therefore, further clinical experience is needed to identify these patients and to choose the time for surgery. 2, biliary source of severe acute pancreatitis, especially with obstruction or cholangitis, should choose to drain through the nasal bile duct, endoscopic duodenal papillotomy or gallbladder puncture and placement of drainage, such as these methods can not be effective drainage, should be early surgery, or emergency surgery. 3, usually the time of necrosis combined with infection is after 2 weeks, but we have observed that a few patients can develop peripancreatic infection and even infectious shock within 2 weeks. For such patients, it is not advisable to stick to 3-4 weeks after surgery, otherwise the timing of surgery will be delayed. 4, early SAP often has intra-abdominal hypertension, and even the emergence of inter-abdominal compartment syndrome, resulting in serious organism pathophysiological disorders, early surgery to reduce pressure and drainage, which is conducive to interrupting the vicious cycle of pathophysiology.