Objective：To study the rational therapeutic regimen in the treatment of severe acute pancreatitis (SAP). Methods:One hundred and fifty-eight cases of SAP were admitted to our department during the past 20 years (from 1980 to 1998),comparison was made between 73 cases in group A who were treated mainly by early operation and 85 cases in group B who were treated nonoperatively in the terms of complications rate, the mean hospitalization days and the hospitalization fee. Results:The incidence of complication, the mean hospitalization days and the hospitalization fee was lower in group B than in group A (P＜0.01). Conclusion:It is an effective methods to adopt the combined nonoperative treatment in early SAP, and surgical operation is a rational addition.