Difficulties and disputes in the diagnosis and treatment of severe acute pancreatitis        MIAO Yi. Center for Pancreatic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Abstract    Acute pancreatitis（AP）, especially severe acute pancreatitis（SAP）, is an abdominal emergency with dismal prognosis. With necrosis of pancreatic and parapancreatic tissue, and/or organ failures, SAP is associated with a mortality rate around 10%～30%. Controversies remains in several aspects of the diagnosis and treatment for SAP, such as prophylactic antibiotics, application of somatostatin analogues, timing and type of intervention in biliary pancreatitis, diagnosis criteria, timing of intervention and surgical procedure for infected necrosis in SAP.