Because of improvements in the management including better diagnostics and treatment modalities, the mortality of acute pancreatitis (AP) has declined during the past 2 decades. With the development of evidence-based medicine, more and more guidelines in AP are published and the management is trended to convincing scientific evaluations. Appropriate early managements are the important step and critical time to alleviate pancreatic necrosis, relief organ dysfunction and improve prognosis. It is necessary to identify the causes and severity of AP before treatment, so as to take etiotropic therapy and intensive care or not. AP is divided as mild and severe type according to the Atlanta Symposium criteria. The severity of AP is mainly determined by Ranson score, APACHE Ⅱ, CT, CRP, et al. The early management of AP is including adequate fluid resuscitation, sufficient oxygen, preventing infection, sedation, analgesia, nutritional support, inhibiting pancreatic exocrinosity, promoting enterocinesia, blood filtration and small dose glucocorticoid infusion. A few patients maybe need surgery for the causes and local complications.
