目的探讨急性胰腺炎患者早期ＥＲＣＰ及内镜治疗应用的价值及安全性．方法急性胰腺炎患者作早期（１ｄ～７ｄ内）ＥＲＣＰ及内镜治疗（ＥＲＣＰ组，６６例），并以同期保守治疗的急性胰腺炎患者６０例作对照（对照组），观察两组患者血清淀粉酶恢复时间，腹痛缓解时间、住院天数、住院费用及并发症发生情况．结果ＥＲＣＰ组中，３６例为胆道疾病患者，４例为胰管结石，４例为胰腺分裂症，３例为乳头旁巨大憩室，１７例ＥＲＣＰ未见异常．作内镜下治疗３３例，其中ＥＰＴ及取石术１７例，４例作了副乳头切开及扩张术，１２例作了鼻胆管引流术．ＥＲＣＰ组腹痛缓解天数及平均住院天数分别为１１５ｄ±３６ｄ及２１７ｄ±５０ｄ，明显短于对照组（１５４ｄ±７８ｄ及３３０ｄ±６８ｄ，Ｐ＜００１）．血清淀粉酶恢复时间及住院费用两组相差不显著．两组均未发生严重并发症．结论急性胰腺炎早期ＥＲＣＰ及内镜治疗经济安全、有效，可缩短腹痛缓解时间及住院天数，作者认为对胆源性胰腺炎应尽早行ＥＲＣＰ及内镜治疗． Objective To investigate the value and safety of early ERCP and endoscopic treatment in patients with acute pancreatitis. Methods The acute pancreatitis patients were treated with ERCP and endoscopic therapy (ERCP group, 66 cases) early and 60 cases of acute pancreatitis (control group) Amylase recovery time, abdominal pain relief time, hospitalization days, hospitalization costs and complications. Results Among the ERCP group, 36 cases were diagnosed as biliary tract disease, 4 cases were pancreatic duct stones, 4 cases were pancreatic schizophrenia, 3 cases were giant papillary diverticulum, and 17 cases were abnormal in ERCP. Endoscopic treatment for 33 cases, of which 17 cases of EPT and lithotomy, 4 cases of deputy nipple incision and expansion, 12 cases of nasobiliary drainage. The days of abdominal pain relief and average length of stay in ERCP group were 115 ± 36 d and 217 ± 50 d, respectively, which were significantly shorter than those in control group (154 ± 78 days and 330 ± 68 days, P <001). Serum amylase recovery time and hospitalization costs were not significantly different between the two groups. No serious complications occurred in either group. Conclusion Early ERCP and endoscopic treatment of acute pancreatitis is economical and effective, and can shorten the time and length of hospital stay. The author believes ERCP and endoscopic treatment of biliary pancreatitis should be performed as soon as possible.