Objective To explore indications of the conservative therapy an early operative treatment for severe acute pancreatitis and researching comprehensive therapeutic rule.Methods Retrospective analyze the clinical feature and the result as making a diagnosis and giving treatment of 82 cases of SAP admitted from Aug.1986 to dec.2000.Results Among them,28 cases underwent conservative treatment,with the cure rate of 85.7%,54 cases underwent conservative treatment,with the cure rate of 81.5%,the total cure rate was 82.9%.Conclusions The conservative therapy or early operation of SAP is determined by the patients' clinica feature,while the supportive conservative therapy being on,we should carefully observe the changes of the patient's condition and the response to therapy,when once surgical indication being discovered,early operation should be performed ,the emergency surgery should be performed as soon as possible for the biliary obstruction of SAP.