Introduction: Gallstone-related acute pancreatitis is one of the most frequent forms of the condition, accounting for around 40% of all cases. Approximately 3% to 8% of patients with symptomatic gallstones may experience acute pancreatitis, with a higher prevalence among females aged 50–70. Recurrent episodes are common, increasing the risks of complications and mortality.

Materials and Methods: A prospective observational study was conducted from June 1, 2021, to May 31, 2022, including 105 patients with mild to moderate biliary pancreatitis admitted to the Department of Surgery, GMCH. Patients were managed with either early cholecystectomy (<7 days from admission) or delayed cholecystectomy (>6 weeks), based on patient consent. Standard hematological and imaging assessments were performed.

Results: Among the 105 participants, 45 (43%) were male and 60 (57%) female, with the highest incidence (31.4%) in the 51–60 age group. Abdominal pain was universal, followed by vomiting (91%), jaundice (29%), and fever (17%). Early cholecystectomy was performed in 75 patients, and delayed surgery in 30. Hospital stay was significantly shorter and cost lower in the early group, with no readmissions, unlike the delayed group, where 12 readmissions occurred.

Conclusion: Laparoscopic cholecystectomy performed during the initial hospital stay for mild to moderate biliary pancreatitis is safe, effective, and prevents recurrence, making it the preferred approach.