Objectives To identify the effect of procalcitonin (PCT) on the choice of operating time for severe acute pancreatitis and assessment of postoperative complications by monitoring the level of serum PCT and recording the incidence of postoperative complications. MethodsNinety-three patients who underwent debridement and drainage of infected necrosis from Sep. 2009 to Dec. 2011 were included. Serum PCT was tested on the day of admission (0 day), one week after admission, one day before surgery, one day after surgery, and one week after surgery. According to the level of serum PCT, all the 93 patients were divided into 3 groups:low level group (PCT < 2 ng/mL), middle level group (PCT 2-10 ng/mL), and high level group (PCT > 0 ng/mL). Postoperative complications were also recorded. ResultsThe incidence of postoperative complications was 19.4% (18/93). There were postoperative bleeding in 13 patients, intestinal fistula in 14 patients, pancreatic fistula in 18 patients, pulmonary infection in 4 patients, residual abscess in 10 patients; re-operation in 15 patients, and death in 8 patients (the death rate was 8.6%). Besides the pulmonary infection, and grade A and C of pancreatic fistula, the incidence of various complications in middle level group and high level group were lower than low level group (P < 0.05). Patients with complications had significantly higher PCT value in one week after admission than onset (P < 0.05). PCT value was higher in the patients with intestinal fistula and residual abscess on one day after operation than on one day before operation (P < 0.05). Patients who died or with re-operation had significantly higher PCT value in one week after operation than on one day after operation (P < 0.05). In the dead patients, the serum PCT sustained at a high level after operation. ConclusionsThe level of serum PCT is correlated with the incidence of postoperative complications. Dynamic monitoring the level of serum PCT can guide the choice of operative time and assessment of postoperative complications including intestinal fistula, pulmonary infection, and death, which can greatly improve the prognosis of SAP.