Background: Acute biliary pancreatitis (ABP) is a frequent and potentially severe form of pancreatitis caused primarily by gallstones or biliary sludge. Early diagnosis and evaluation of laboratory parameters play a vital role in determining disease severity and guiding appropriate management.

Objective: To evaluate the spectrum of deranged laboratory parameters in patients with acute biliary pancreatitis and assess their association with clinical presentation and disease severity.

Methods: This prospective observational study was conducted at Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, from July to December 2022. Fifty patients diagnosed with ABP were included. Diagnosis was based on clinical features, elevated serum pancreatic enzymes, and imaging findings suggestive of biliary etiology. Relevant laboratory investigations, including liver and renal function tests, inflammatory markers, and electrolytes, were recorded and analyzed.

Results: Of the 50 patients, 64% were female, with a mean age of 53.04 ± 14.38 years. Abdominal pain (100%) and vomiting (72%) were the most common symptoms. The majority had mild (54%) or moderate (40%) disease. All patients showed elevated serum amylase (1871.12 ± 1700.39 IU/L) and lipase (2606.43 ± 2289.57 IU/L). Liver enzymes were deranged in over half the patients. Inflammatory markers such as CRP and WBC were elevated in 70% and 72% of cases, respectively. Electrolyte disturbances and renal dysfunction were also noted in a subset.