Biliary pancreatitis occurs when gallstones develop in your gallbladder and block the duct that leads through your pancreas to your small intestines. Gallstones develop from hardened pieces of digestive fluid.

In general, pancreatitis is a condition involving inflammation of your pancreas. It can be acute or chronic. Acute pancreatitis develops quickly and usually resolves within several days with proper treatment. Chronic pancreatitis develops slowly over time from ongoing tissue damage.

Biliary pancreatitis, also known as gallstone pancreatitis, is the most common cause of acute pancreatitis. In the United States, around 200,000 hospital admissions happen each year due to acute pancreatitis. Biliary pancreatitis makes up about 35% to 40% of cases.

Read on to learn more about biliary pancreatitis, including symptoms, causes, and treatment options.

Biliary pancreatitis can cause symptoms such as:

Biliary obstruction often causes sharper pain than other causes of acute pancreatitis. According to the American College of Gastroenterology, it involves a squeezing type pain, most often in the left upper abdomen or back. It usually reaches peak intensity within 30 minutes and persists for more than 24 hours at a fairly constant intensity.


It’s important to get immediate medical attention if you have symptoms of acute pancreatitis, as there’s a risk of life threatening complications, such as multiple organ failure or severe damage to the pancreas.

Gallstones cause biliary pancreatitis by getting stuck in the duct that leads from your gallbladder to your small intestines via your pancreas. This blockage causes enzymes to back up into your pancreas, leading to damage and inflammation of your pancreas.

The risk of developing biliary pancreatitis seems to be higher in people with gallstones less than 5 millimeters in diameter. These stones are small enough to enter the ducts of your gallbladder but might not be big enough to pass through. In very rare cases, gallstones can be greater than 5 centimeters, which is about 2 inches in diameter.

What causes gallstones?

According to research, the risk of biliary pancreatitis in people with gallstones is 7%.

Gallstones form when bile inside your gallbladder contains too much cholesterol, bilirubin, or insufficient bile salts.

Researchers aren’t entirely sure why these changes occur. Biliary pancreatitis and, by extension, gallstones may be more likely to occur in:

  • females
  • older people
  • people with more weight
  • individuals with high cholesterol
  • those taking birth control or hormone replacement pills
  • people experiencing rapid weight loss
  • individuals with diabetes
  • pregnant people

Doctors often diagnose biliary pancreatitis with a combination of results from your medical history, physical exam, imaging, and blood tests.

People need to meet two of the following three criteria for an acute pancreatitis diagnosis:

  • upper abdominal or back pain consistent with pancreatic pain
  • increased lipase or amylase levels (digestive enzymes) more than three times the upper limit of typical levels
  • abdominal imaging showing pancreatic inflammation

Imaging can show doctors the extent of the inflammation and the severity of pancreatitis. Imaging techniques include:

Doctors often use ultrasound as the initial imaging test. It can correctly identify biliary pancreatitis about 84% of the time.

Your doctor may order blood tests to check:

Early treatment is important for acute pancreatitis. It’s a good idea to receive treatment for biliary pancreatitis at a hospital to minimize the risk of complications and have a doctor assess the extent of inflammation.

At the hospital, you may receive:

  • intravenous (IV) fluids to treat dehydration if you’re vomiting and can’t keep fluids down
  • pain medications and antibiotics by mouth or through an IV if you have an infection
  • a low fat diet or nutrition through an IV

You may need a procedure called endoscopic retrograde cholangiopancreatography. During this procedure, doctors use an X-ray to guide a long, thin tube down your throat to remove gallstones.

Gallbladder removal

Your doctor may recommend a procedure called cholecystectomy to remove your gallbladder once inflammation symptoms subside.

Experts recommend gallbladder removal after mild biliary pancreatitis to avoid the risk of future gallbladder problems.

However, there’s some debate about when to remove the gallbladder. In a 2022 study, researchers found that the optimal time for gallbladder removal was within 8 weeks of hospital discharge for biliary pancreatitis with necrosis (a loss of blood supply that causes part of the pancreas to die).

Most people with acute pancreatitis have mild disease, but 15% to 20% of cases are severe. Around 20% to 30% of severe cases lead to death. Severe pancreatitis usually involves pancreatitis with organ failure for more than 48 hours.

Complications of acute pancreatitis can include:

Early diagnosis and treatment can prevent complications that lead to death, like multiple organ failure and pancreatic necrosis.

Gallstones can cause biliary pancreatitis. Lowering your risk of developing gallstones may also lower your risk of developing biliary pancreatitis.

Researchers aren’t entirely sure why gallstones form, but there’s a limited amount of evidence that some lifestyle habits can contribute to them.

You may be able to lower your risk of gallstones by:

  • managing weight if you have more weight, which may lower the amount of cholesterol in your bile
  • avoiding foods that are high in saturated fat, such as:
    • full-fat dairy products
    • sausage and fatty meat
    • cakes, biscuits, and baked goods
    • coconut or palm oil
  • consuming plenty of fruits and vegetables
  • eating nuts, such as peanuts or cashews

Biliary pancreatitis is the most common cause of acute pancreatitis. It occurs when gallstones get stuck in the ducts that lead from your gallbladder to your small intestines through your pancreas. This blockage can lead to a backup of pancreatic enzymes inside the pancreas. This can cause inflammation of the pancreas.

Most cases of biliary pancreatitis are mild and usually resolve within about a week with proper treatment. To reduce the risk of severe complications, it’s important to get medical attention if you have symptoms of biliary pancreatitis.