From 1986 to 1990 1,577 patients were treated for acute pancreatitis. Destructive forms were found in 585 (37.1%) patients. Clinical, laboratory, roentgenological, endoscopic, and radiation methods were employed in establishing the diagnosis. Laparoscopy was the most informative method which combined successfully diagnostic and therapeutic aspects. Operations were performed on 165 patients with complicated forms of acute pancreatitis. The remaining 1,412 patients received nonoperative treatment including laparoscopic drainage. Total mortality 2.29%, postoperative mortality 21.29%.