Abstract: Objective:To investigate the clinical effect and prognosis with ultrasoundguided percutaneous retroperitoneal catheterization and preperitoneal drainage for the treatment of severe acute pancreatitis.Methods:98 cases of surgical treatment of severe acute pancreatitis patients，using random numbers table patients were divided into control group （after ultrasoundguided percutaneous peritoneal drainage tube） and the experimental group （first abdominal puncture drainage treatment，and then after ultrasoundguided percutaneous peritoneal drainage tube），49 cases in each group.Compared two groups of patients with postoperative peripheral blood leukocyte levels back to normal time，organ failure rate，the length of time needed for the statistical differences，compared two groups of patients before and after the treatment （7 d） postoperative bladder pressure，APACHEⅡ score，content of TXA2 and PGI2 levels of statistical significance，compared two groups of patients after treatment clinical curative effect of statistical significance.Result:The recovery time of WBC in the experimental group [（22.31±1.96）d] was lower than that in the control group [（26.84±2.07）d]，and the organ failure rate in the experimental group （34.69%） was lower than that in the control group （57.14%），the differences were statistically significant（P<0.05）.After treatment，treatment group patients with APACHEⅡ score（6.94±3.22） was significantly lower than the control group patients（11.91±3.86）（P<0.05）；After treatment，TXA2[（146.53±20.61）ng/ml] in the experimental group was significantly lower than that in the control group [（218.21±17.94）ng/ml]（P<0.05），and PGI2[（173.54±15.38）ng/ml] in the experimental group was significantly higher than that in the control group[（146.47±16.12）ng/ml].The recovery rate in the experimental group was significantly higher than that in the control group（P<0.05）.Conclusion:Ultrasoundguided percutaneous retroperitoneal catheterization and preperitoneal drainage for the treatment of severe acute pancreatitis can significantly improve the prognosis of patients，reduce organ system failure，and improve clinical efficacy.

Key words: percutaneous retroperitoneal catheterization and drainage, severe acute pancreatitis, peritoneal puncture drainage, ultrasonic