Abstract
OBJECTIVE: To evaluate the clinical outcomes of minimally invasive step-up surgery in patients with severe acute pancreatitis (SAP). METHODS: A retrospective cohort analysis was conducted, involving 96 consecutive SAP cases. The control group (n=46) underwent conventional open surgery, while the research group (n=50) received minimally invasive step-up procedures. Comparative assessments included operative parameters, recovery of intestinal function, nutritional markers, disease severity, immune function, serum inflammatory biomarkers, clinical safety, and prognostic outcomes. RESULTS: Despite a markedly higher frequency of surgical interventions, the research group showed significantly reduced operative duration, shorter postoperative recovery time for intestinal function, and shorter hospitalization duration compared to the control group. Postoperatively, patients in the research group exhibited superior nutritional markers, enhanced immunological function, and notable alleviation of disease severity. Systemic infections were less frequent in the research group, with an obviously reduced fatality rate. Other complications and the total complication rate did not differ significantly between groups. CONCLUSION: Despite necessitating additional surgical interventions, the minimally invasive step-up approach for SAP features shorter surgical times, faster recovery of intestinal function, and a lower mortality rate.