ObjectiveTo explore the safety and feasibility of retrolaparoscopy in treatment of severe acute pancreatitis complicated with infected pancreatic necrosis. MethodsClinical data of 20 patients with severe acute pancreatitis complicated with infectious pancreatic necrosis who received retrolaparoscopy treatment in our hospital from May 2017 to May 2022 were retrospectively collected. ResultsAmong the 20 patients, 18 patients underwent percutaneous catheter drainage, 1 pregnant patient with severe acute pancreatitis underwent laparotomy drainage in the first phase, and 1 patient underwent laparotomy drainage in the first phase from another hospital. All patients underwent successful retroperitoneal drainage, microscopic debridement and drainage were performed. The operation time was 68–106 minutes, (89.8±11.7) minutes; intraoperative bleeding was 100–300 mL, (171.3±61.0) mL; hospitalization was 28–62 d, with median time of 48 d. After the operation, the systemic poisoning symptoms of the patients were quickly relieved. One patient underwent twice retroperitoneoscopic debridement surgeries, and the remaining patients underwent only once retroperitoneoscopic debridement drainage surgery. There were no complications in 17 patients, but 1 patient was complicated by colonic fistula after surgery, 2 patients suffered from abdominal bleeding. After the operation, 20 patients were interviewed, and the follow-up time was 6–62 months, with the median of 31 months. During postoperative follow-up period, the patients’ symptoms completely disappeared and there was no recurrence. ConclusionThe retrolaparoscopic approach in treatment of severe acute pancreatitis complicated with infected pancreatic necrosis is safe and effective, and has few complications.