Background and Aims Acute biliary pancreatitis (ABP) is a frequently encountered disease in clinical practice, for which the most common cause is choledocholithiasis. The mainstream view at present is that endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) and endoscopic naso-biliary drainage (ENBD) should be performed as early as possible for patients with ABP in early stage. However, the necessity of synchronous pancreatic duct stent drainage during above treatment is still a matter of debate. Therefore, considering this problem, this study was conducted to further investigate the clinical value of pancreatic duct stent placement in the treatment of ABP by an efficacy comparison between two groups of ABP patients receiving EST plus ENBD with or without pancreatic duct stent placement.Methods The clinical data of 70 ABP patients treated in the People's Hospital of Ningxia Hui Autonomous Region from January 2015 to January 2020 were retrospectively analyzed. Of the patients, 30 cases underwent emergency operation of EST plus ENBD combined with pancreatic duct stent drainage within 72 h after onset with regular conservative treatment (observation group), and 40 cases underwent emergency operation of EST plus ENBD within 72 h after onset with regular conservative treatment. The clinical improvements and overall outcomes of the two groups of patients were compared.Results There were no significant differences in sex, age, time from onset to EST, and preoperative laboratory parameters between the two groups of patients (all P>0.05). The time to pain relief, length of hospitalization, and time for the serum amylase to return to normal in observation group were significantly shorter than those in control group (all P<0.05). The time lengths for normalization of the levels of transaminases and bilirubin showed no statistical difference between the two groups (all P>0.05). Death occurred in one patient (3.3%) in observation group and in two patients (5.0%) in control group; the incidence of complications (peripancreatic fluid collections, pancreatic pseudocyst, pancreatic ascites) was 6.67% in observation group and 17.5% in control group; ultrasound or CT guided puncture and drainage was required in one patient (3.3%) in observation group and in 3 patients (10%) in control group; surgical debridement was performed in none of the patients in observation group and in one patient in control group; ICU admission was required for one patient in observation group and 4 patients in control group. All above clinical outcome variables in observation group were superior to those in control group, but all differences did not reach statistical significance (all P>0.05).Conclusion Application of pancreatic duct stent drainage in the treatment of ABP patients can quickly alleviate the clinical symptoms, and may also decrease the incidence of complications, improve the outcomes and increase the overall efficacy. The pancreatic duct stent placement is recommended during performing EST plus ENBD procedure for ABP patients in early stage.