Surgical treatment for severe acute pancreatitis has not yet yielded satisfactory results. Several factors which might affect the surgical results of severe acute pancreatitis were analyzed in this study. The presence or absence of infection was not important as a factor determining the surgical results. The severity scores and some biochemical parameters such as CRP, IL-6, PMN-E, HGF seemed to be closely related to surgical results. It was likely that a significant decrease in lymphocyte counts in the blood on admission was closely related to the prognosis of the surgical patients. Timing and procedures for surgery should be more seriously considered in the treatment for patients with such poor general conditions.