Objective To investigate the timing of surgery for biliary surgical disease in acute biliary-derived edematous pancreatitis. Methods Retrospective analysis of the clinical data of 86 patients with acute biliary edema-type pancreatitis. Results: 37 cases of mild non-obstructive type were treated conservatively without aggravation, and 2 weeks after remission, elective surgery was performed for biliary surgical disease, 7 cases of complications occurred, and the average hospital stay was 23.5 d. Among 49 cases of mild obstructive type, except for 3 cases of aggravation within 24-72 h, which were referred to emergency surgery, the remaining 46 cases were stabilized by non-surgical comprehensive treatment, and 21 cases (45.65%) were operated early for biliary surgery Except for 2 cases of death, there was no recurrence of acute cholangitis or pancreatitis in the whole group after surgery. There was no statistically significant difference in complication rate, hospitalization days and morbidity and mortality rate between the two types of patients in the elective surgery group (P〉0.05), while there was a statistically significant difference in complication rate between the early surgery group and elective surgery group in the mild obstruction type (P〈0.05). Conclusion For the early stage (within 1 week) of definite acute biliary edema type pancreatitis, biliary obstruction or not can be cured by most of the non-surgical comprehensive treatment measures, and timely elective surgery for biliary surgical disease after the inflammatory edema of the pancreas has subsided and the condition has stabilized can reduce the occurrence of complications.