Abstract: Treatment of acute pancreatitis is a complex and far from final solution of the problem of emergency surgery of the abdominal cavity. First of all, this is due to the complexity of the pathogenesis and sometimes unpredictability of the course of the disease. Despite some success achieved in recent decades in conservative and surgical treatment, the mortality rate in acute pancreatitis is still quite high and, according to various authors, ranges from 5 to 74 %. Moreover, the share of purulent complications among the causes of death of patients accounts for 57-80 %. Postoperative mortality in acute aseptic necrotic pancreatitis is 21-25 %, in infected patients-35-40 %. Acute necrotic pancreatitis is a dynamically developing inflammatory process characterized by two peaks of mortality, which clearly reflect, in fact, two different stages (phases) of the development of acute necrotic pancreatitis. The first peak is observed in the first 3-5 days from the onset of the disease. The most common cause of death is endotoxin shock and multiple organ failure syndrome, most often due to the development of subtotaltotal necrotic pancreatitis. At the initial stage of the disease, the inflammatory process both in the gland itself and in the retroperitoneal tissue is aseptic. During this period (in the phase of aseptic inflammation), acute aseptic parapancreatic fluid accumulations occur in the omentum and/or retroperitoneal tissue, enzymatic peritonitis, pancreatic pseudocysts begin to form, etc.as a response of the body to necrosis of the pancreas and retroperitoneal tissue. Thus, at this stage, acute aseptic necrotic pancreatitis develops. Currently, for the treatment of acute necrotic pancreatitis, a fairly wide range of surgical interventions is used — cavity (laparotomy), extraperitoneal mini-access (lumbotomy), laparoscopic, endoscopic, puncture-draining interventions under ultrasound control. However, the choice of the method and scope of surgical intervention, the timing of its implementation, and the sequence of application of a particular operation at the stages of treatment remain debatable. These data indicate the urgency of the problem and many unresolved issues, which strongly dictates the need for further search for new approaches to the treatment of such a serious and complex disease as acute pancreatitis