Introduction. Pancreatic necrosis — acute surgical disease accompanying high rates of mortality and complications. Material and methods. The analysis of the treatment of 256 patients with pancreatic necrosis moderate and severe degrees. In the control group was conducted basic therapy, the main (n=158), which further were administered high doses of octreotide and endoscopic stenting of the main pancreatic duct to decrease the intraductal pressure, prevention and treatment of internal pancreatic fistula. Results and discussion. In the main group in contrast to the control is marked by a more rapid decline in the level of amylase, lipase and leukocyte index of intoxication. The infection occurred in the basic — 11%, control 20% died in the study group — 3%, control — 9%.