Abstract: Objective To observe the clinical outcomes of patients with severe acute pancreatitis(SAP) after operation. Methods Clinical data about 44 SAP patients admitted to our hospital from January 2008 to January 2012 were retrospectively analyzed. The patients were divided into operation group(n=34) and non-operation group(n=10). Following data were compared, including their clinical outcomes(cured, improved or died), total hospital stay time, total hospitalization cost, enteral nutrition starting time and post-operational recovery. Results No significant difference was found in the indications at admission and in the clinical outcomes between the two groups(P> 0.05). The hospital stay time and enteral nutrition starting time were significantly shorter while the total hospitalization cost was significantly less in operation group than in non-operation group(32.7 vs 45.6 days, 19.8 vs 27.1 days, 128 000 vs 153 000 RMB(Yuan), P< 0.05). The amount of bleeding was small during operation and few or no complications occurred after operation. Conclusion Operation at a selective time for SAP patients with operation indications can reduce their hospital stay time, alleviate their suffering, and improve their survival rate.