Aim. To improve the results of acute necrotic pancreatitis management via an analysis of changes in the main causes of mortality in patients with this disease over the last decade. Material and methods. We have analyzed medical records of patients with acute necrotic pancreatitis followed by lethal outcome for the period 2015—2016. In all cases autopsy was performed in order to determine morbidity and mortality. Complications of pancreatic necrosis significant for tanatogenesis, treatment and prevention strategy were compared with those for 2005—2006. Results. It was shown that not only significantly decreased mortality in acute necrotic pancreatitis but also important changes in its structure occurred for the last ten years. At present time DIC-syndrome and its organ complications are the most significant causes of death. Conclusion. Prevention of DIC-syndrome and its complications is necessary to improve the outcomes. Endothelial protectors’ administration in early period, timely diagnosis and adequate treatment of DIC-syndrome are advisable.