In recent years, the clinical trend of acute biliary pancreatitis has increased, and studies have found that biliary stones are the main cause. In today’s rapid development of minimally invasive surgery, how to cure this dangerous clinical emergency abdomen quickly and well is the focus of attention. Acute biliary pancreatitis is a relatively common clinical emergency abdomen. Small stones in the gallbladder that migrate downward or stones in the end of the common bile duct are important causes of this disease, followed by biliary tract infection. The treatment of acute biliary pancreatitis is a comprehensive application of removing stones, relieving obstruction, controlling infection, and unobstructing drainage. In the past, when endoscopic and lumpectomy techniques were not developed, open surgery was the most popular choice to achieve the above purposes. Open surgery is very traumatic, and adding surgical blows in the case of acute pancreatitis causing damage to multiple organs of the body is undoubtedly adding insult to injury, which is also the main reason for the high morbidity and mortality rate and high complication rate of the disease in the past. As technology advances and minimally invasive technology enters the fast lane of medical technology, endoscopic treatment of the disease becomes more and more important. Duodenoscopy is an important and most used endoscope in the treatment of acute biliary pancreatitis. Duodenoscopy is preferred in patients with extrahepatic bile duct stones cholangitis and biliary obstruction, not only for clear diagnosis, but also for stone removal. Microscopic incision of the papillary sphincter and placement of a nasobiliary tube for continuous biliary drainage is applied the sooner the better in patients with jaundice of unknown origin, or in patients with acute obstructive purulent cholangitis in critical condition, with the best time for treatment being within 72 hours of onset. Laparoscopy and cholangioscopy are used as adjunctive endoscopes in surgery for gallbladder stones and giant extrahepatic bile duct stones. The combination of the three scopes is a perfect complement to each other, showing the advantages of minimally invasive surgery.