To the Editor: Piavcik and her colleagues1 from Poland are to be congratulated for the randomized controlled study of the value of continuous regional arterial infusion (CRAI) for severe acute pancreatitis (SAP), reported in a recent issue of Pancreas. For years now, our Japanese colleagues have attempted to convince us of the efficacy of the CRAI approach to patients with SAP. 2, 3 However, more widespread adoption of CRAI as a therapy for SAP has been delayed by the absence of evidence-based confirmation. 4 That evidence may now be here. The findings of this study that guided infusion of a protease inhibitor and an antibiotic directly into a regional pancreatic artery within 72 hours after the onset of SAP results in significant decreases in overall mortality and the need for urgent surgery compared with a control group of intravenous antibiotics alone are important for the future therapy for SAP. It is widely appreciated that the only previously documented therapeutic measures for SAP have been aggressive fluid resuscitation and organ support in a controlled intensive environment. Continuous regional arterial infusion may, indeed, provide the third form of documented therapy for SAP.