Objective: To set up principles for the treatment of severe acute pancreatitis (SAP).
Methods: The therapeutic principles and results of SAP in three periods were analyzed. Period I (1980 - 1990) was characterized by early surgical intervention supplemented with integrated traditional and western medical therapy, period II (1991 - 1993) by integrated traditional and western medical therapy supplemented with surgery for early complications, and period III (1994 - 1997) by integrated traditional and western medical therapy supplemented with surgery for local infectious complications only.
Results: Because of the improvement of intensive care, the operation rates kept declining in the three periods. They were 77.59%, 54.55% and 29.55% with a mortality rate of 40.52%, 17.17% and 11.36%, respectively.
Conclusions: Integrated traditional and western medicine has been effective in most SAP patients, and surgery is indicated only for late complications such as necrotizing infection. Early surgery should be restricted.