Objective To observe the efficacy and safety of endoscope and laparoscope in treatment of acutebiliary pancreatitis.Methods 84 patients with acute biliary pancreatitis from January 2010 to January 2014 in our hospital during treatment were randomly divided into the study group and control group according to the random num-ber table methods,42 cases in each group.The control group was treated with conservative treatment of department of internal medicine,while the study group was treated with duodenoscopy combined with laparoscopy.To observe and compare the efficacy and adverse reactions of two groups.Results Temperature returned to normal time,abdominal pain relief time,recovery time of amylase in urine,recovery time of biochemical index,hospitalization time and cost of hospitalization of the study group after treatment were (3.44 ±1.63)d,(4.73 ±1.12)d,(7.82 ±3.31)d,(9.81 ± 6.42)d,(12.43 ±4.61 )d,which were significantly lower than (5.94 ±2.43)d,(7.53 ±2.12)d,(11.72 ± 2.21)d,(18.41 ±8.62)d,(20.33 ±6.21)d of the control group(t =3.90,4.02,4.26,4.50,5.01,all P <0.05). 2 cases of the study group occured biliary tract bleeding,2 cases with pancreatic pseudocyst,1 case with wound infec-tion,there was no recurrence,the incidence rate of adverse reaction was 11.90%;3 cases of the control group after treatment occurred pancreatic pseudocyst,2 cases with abdominal cysts,5 cases with recurrence,1 case with acute respiratory distress syndrome (ARDS),1 case with renal failure,the incidence rate of adverse reactions was 28.57%, which of the control group was significantly higher than the study group (χ2 =4.21,P <0.05 ).Conclusion Duodenal endoscopy combined with laparoscopy has good clinical effect,shorter hospitalization time,less cost,less adverse reaction and the recurrence rate is low in treatment of acute biliary pancreatitis,which has high application value.