Acute biliary pancreatitis is the most common form of pancreatitis and often requires surgical intervention. Depending on the presence of stones, the severity of the disease, and the presence of combined cholangitis, minimally invasive cholecystectomy, or/and ERCP may be performed, which can sometimes be risky. Therefore, the indications and timing must be individualized. With a clear diagnosis, I generally complete minimally invasive cholecystectomy and ERCP early, in one stage. the relevant indications and contraindications have recently been published in authoritative journals for reference. Indications Clinical judgment of common bile duct stones as a possible cause of pancreatitis and the following conditions: 1. cholangitis (fever, jaundice, sepsis) 2. persistent biliary obstruction (combined bilirubin > 5 mg/dl) 3. clinical deterioration (increased pain, increased white blood cell count, deteriorating vital signs) 4. diagnostic imaging confirms the presence of common bile duct stones Contraindications Absolute contraindications 1. the patient is unstable. 2. Patient does not consent to ERCP 3. No well-trained ERCP endoscopist Relative contraindications (may be overcome) Anatomic conditions (gastroduodenal disease or surgical alterations) that would prevent endoscopic access to the major papillae; may be overcome with modified equipment and accessories if long-arm bowel climbing is present Clinically significant or uncorrectable coagulopathy is present can be overcome by placing a biliary stent without papillotomy.