Abstract:ObjectiveTo compare the efficacy and safety of different minimally invasive surgical methods in the treatment of early acute severe biliary pancreatitis. Methods The clinical data of 79 patients with early severe acute biliary pancreatitis undergoing minimally invasive surgery from January 2016 to June 2018 were retrospectively analyzed.According to different surgical methods,they were divided into duodenoscopy group (duodenoscopic surgery,n=42) and laparoscopy group (laparoscopic surgery,n=37).The intraoperative bleeding volume,operation time,complications,recovery and therapeutic effects were compared between two groups. Results The operation time ［(22.97±5.68) min vs (134.52±21.89) min］ and intraoperative blood loss ［(3.19±0.86) ml vs (32.15±2.58) ml］ in duodenoscopy group were significantly lower than those in laparoscopy group (all P<0.05).There were no significant differences in the incidence of complications,hospital stay,recovery time of postoperative body temperature and indicators such as total bilirubin returning to normal,acute physiology and chronic health enquiry-Ⅱ (APACHE-Ⅱ) score before and after surgery,mortality and cure rate between two groups (all P>0.05). Conclusion Both duodenoscopic surgery and laparoscopic surgery are the effective methods for the treatment of early severe acute biliary pancreatitis with similar efficacy and safety.