In this retrospective study, 78 patients with acute biliary pancreatitis underwent endoscopic retrograde cholangio-pancreatography (31 men, 47 women; median age 61 years). It was a severe pancreatitis in 70% cases. The median time from admission to endoscopic sphincterotomy was 4 days. Endoscopic sphincterotomy was performed in 73 patients (93.3%). Bile duct clearance was achieved in 69 patients (88.37%). Overall, the complication rate was 7%. All the patients recovered after endoscopic sphincterotomy. Surgery was necessary in 40% cases.