Objective: To investigate the method and timing of surgical treatment of biliary duct diseases in patients with acute biliary pancreatitis (ABP). Methods: The clinical data of 206 ABP patients undergoing surgical treatment for bile duct diseases were retrospectively analyzed. Of the patients, 192 cases had mild disease, 2 cases had moderately severe disease, and 12 cases had severe disease. The surgical procedures included cholecystectomy, choledocholithotomy-T-tube drainage, ERCP and partial hepalobectomy. Results: All patients with moderately severe or severe ABP underwent early surgical treatment after non-surgical treatment. In patients with mild ABP, the time of antibiotic administration, overall length of hospital stay and hospitalization cost were significantly reduced in cases undergoing early surgical treatment (within two weeks of onset) compared with those undergoing delayed surgical treatment (after two weeks of onset), and the time of antibiotic administration, overall length of hospital stay and total cost in cases undergoing surgical treatment during admission were significantly reduced compared with those undergoing elective surgery (all P<0.05). Conclusion: Biliary tract surgery in ABP patients should be tailored according to patient’s specific condition, which should be performed during the time of same admission and early after onset for mild cases, and in severe cases, it should be performed as soon as possible after the relief of the overall conditions by non-surgical treatment. Emergency surgery or ERCP should be performed for those with biliary obstruction or cholangitis regardless of mild or severe presentation.