AIM:Based on the pathogenesis of severe acute pancreatitisand our experimental studies,to investigate the effect ofdexamethasone and dextran in treatment of patients withsevere acute pancreatitis.METHODS:Thirty-two patients with severe acute pancreatitiswere treated with 0.5-1 mg/kg per day dexamethasone for3-5 d,and 500-1 000 mL/d of dextran 40 for 7 d,besidesthe routine therapy.RESULTS:After 4-8 h of treatment,abdominal pain beganto be relieved;range of tenderness began to be localized in27 patients.They were cured with nonsurgical treatment.Five of them were deteriorated,and treated with surgery.Four patients in this group died.CONCLUSION:Dexamethasone and dextran 40 block thepathologic process of severe acute pancreatitis throughinhibition of inflammatory mediators and improvement ofmicrocirculation disorders respectively. AIM: Based on the pathogenesis of severe acute pancreatitis and our experimental studies, to investigate the effect ofdexamethasone and dextran in treatment of patients with severe acute pancreatitis. METHODS: Thirty-two patients with severe acute pancreatitiswere treated with 0.5-1 mg / kg per day dexamethasone for 3-5 d, and 500-1 000 mL / d of dextran 40 for 7 d, besidesthe routine therapy .RESULTS: After 4-8 h of treatment, abdominal pain beganto be relieved; range of tenderness began to be localized in 27 patients. They were cured with nonsurgical treatment. Five of them were deteriorated, and treated with surgery. Patients in this group died. CONCLUSION: Dexamethasone and dextran 40 block the pathologic process of severe acute pancreatitis through inhibition of inflammatory mediators and improvement of circulatory disorders respectively.