Abstract： Objective To evaluate the efficacy of minimally invasive technique by retroperitoneal approach in the treatment of severe acute pancreatitis with peripancreatic necrosis.Methods The clinical data of 10 patients with severe acute pancreatitis combined with peripancreatic necrosis who underwent retroperitoneal drainage by aspirating and placing tube under B ultrasound guidance on the basis of routine therapy in the First Affiliated Hospital of University of South China from January 2016 to September 2016 were analyzed.Results All of the 10 patients successfully underwent puncture.Drainage was good after puncture and tube placement in 7 patients.The amylase activity was normal within 3 ～ 7 days,and the symptoms of abdominal pain and bloating were alleviated in 2 ～ 4 days.Among them,3 cases had poor drainage after catheterization due to a large necrotic area,and the percutaneous nephroscope was performed to remove the necrotic tissue of the pancreas.Bacteria was detected in the drainage fluid of 7 patients.The complications of pneumothorax,hemothorax and organ injury were not found in all the patients.The average hospitalization time was 19.4 days (10 ～ 34 days).Conclusions Minimally invasive retroperitoneal approach is safe and effective in curing severe acute pancreatitis with peripancreatic necrosis with good efficacy,which is worth for clinical recommendation and application.