Under what circumstances should surgical treatment of acute pancreatitis be considered?

First consider whether the acute pancreatitis is of biliary origin. The indications for surgery in biliary pancreatitis can be viewed in two ways.

1. Absolute indications ① the diagnosis is not clear, can not exclude the existence of other acute abdomen; ② hepatopancreatic jugular abdominal stone embedded or the common bile duct has a stone obstruction, the application of endoscopy can not be removed or stone removal failure; ③ pancreatic necrosis secondary to abdominal infection or the existence of pancreatic abscess.

2. Relative indications: (1) the necrotic pancreatic tissue is not secondary infection, but the lesion is more than 50% of the pancreatic tissue; (2) despite active medical treatment, severe acute pancreatitis persists or further deterioration of the condition, and concomitant with the failure of one or more organs.

Specific indications include: the diagnosis is not certain, but there is acute peritonitis; acute pancreatitis with shock or concomitant biliary stones, biliary roundworms, acute septic cholangitis, obstructive jaundice, pancreatic abscess or pancreatic pseudocyst.