目的:探讨急性胆源性胰腺炎(ABP)患者胆道疾病手术治疗的方法及时机。方法:回顾性分析206例ABP行胆道疾病处理的患者临床资料,其中轻型192例,中重型2例,重型12例;手术方式包括胆囊切除术、胆总管切开取石T管引流术、ERCP、肝叶部分切除术等。结果:中重型及重型ABP患者均在非手术治疗后早期行外科处理;轻型ABP患者中与早期手术者(起病2周内)抗生素使用时间、总住院时间、住院费用较延期手术者(起病2周后)明显减少,同期手术者抗生素使用时间、总住院时间、总费用较择期手术者明显减少(P<0.05)。结论:ABP患者胆道手术方式需根据患者情况选择,轻型患者应在同次住院期间且起病早期行胆道手术治疗;重型患者应在非手术治疗整体情况缓解后尽早行手术治疗;如有胆道梗阻或胆管炎无论轻重均应急诊手术或ERCP。 Objective: To investigate the method and timing of surgical treatment of biliary tract diseases in patients with acute biliary pancreatitis (ABP). Methods: A retrospective analysis of 206 cases of patients with biliary tract disease ABP clinical data, including 192 cases of light, 2 cases of heavy and heavy in 12 cases; surgical methods including cholecystectomy, common bile duct T tube drainage, ERCP, Partial hepatectomy and so on. Results: The patients with severe or severe ABP were treated surgically early after non-surgical treatment. In patients with mild ABP and early surgery (within 2 weeks of onset), antibiotic use time, total hospital stay and hospitalization cost were significantly lower than those with delayed operation 2 weeks later) significantly decreased. The antibiotic use time, total length of hospital stay and total cost were significantly decreased (P <0.05). CONCLUSION: The biliary procedure in ABP patients should be selected according to the patient’s condition. The patients with light type should be treated with biliary tract surgery during the same hospitalization and the early stage of onset. Patients with severe type should undergo surgical treatment as soon as possible after the overall situation of non-surgical treatment is relieved. Or cholangitis regardless of severity are emergency surgery or ERCP.