Gallstones are the most common cause of pancreatitis. About 35% of acute pancreatitis in Europe and the United States is caused by gallstones, and up to 65% in Asian countries. Most acute biliary pancreatitis has a relatively mild clinical course, but 25% of cases progress to severe pancreatitis, which increases the mortality rate significantly and is characterized by recurrent attacks. ERCP and EST are effective in removing obstructing stones and restoring bile drainage, and in separating the common bile and pancreatic ducts with a success rate of more than 90%. The effective use of ERCP makes it necessary to differentiate acute biliary pancreatitis from other causes of acute pancreatitis. Experience has shown that correct diagnosis requires a combination of intensive history taking, physical examination, and laboratory and imaging studies.ERCP is the gold standard for the diagnosis of common bile duct stones.MRCP and ultrasound endoscopy have a high diagnostic yield for the diagnosis of bile duct stones. Treatment The treatment of acute severe pancreatitis remains primarily supportive, including aggressive fluid replacement, adequate nutritional support and pain control, and usually requires ICU monitoring. Early endoscopic treatment as an integrated treatment strategy has been demonstrated by uncontrolled reports and follow-up controlled clinical trials, especially in severe acute biliary pancreatitis. Therefore, patients with pancreatitis, once diagnosed with cholestatic pancreatitis, should be treated aggressively and endoscopic treatment should be performed along with conservative treatment. Intraoperative removal of bile duct stones, release of biliary obstruction and separation of the common biliopancreatic duct channel can reduce the recurrence rate of cholestatic pancreatitis, which would otherwise occur repeatedly.