Acute biliary pancreatitis is a serious disease with many local and distant complications and steadily high morbidity. Properly indicated and suitable timed ERCP is a standardised therapeutic option. In our study group of 104 patients the signs of biliary obstruction assessed by ERCP, biochemical enzymatic changes (transaminase, alkaline phosphatase and gamaglutamyltranspeptidase serum activity) and ultrasound markers were correlated. In our group 72 pts (69%) ERCP pathology of the biliary tree was seen. In this group of 72 pts the highest agreement of biliary obstruction signs correlated to transaminase activity (according to ERCP result in 94%), lower agreement in alkaline phosphatase and gamaglutamyltranspeptidase activity (89%) and serum bilirubin level (84%).The lowest percentage of agreement of urgent ERCP and abdominals ultrasound (77%) was seen but this latter seemed to be the most specific method according to data given by the authors.

        Key words: acute pancreatitis – biliary obstruction – ERCP– abdominal ultrasound