Pancreatitis is the inflammation of the pancreas, which is the most deeply seated organ in the abdomen. It is positioned behind the stomach and the large intestine, and abuts the big arteries and veins of the abdomen. Its strategic location and relation with essentially all the rest of the abdominal organs demonstrates why its inflammation can affect all other organs. When it occurs, pancreatitis has a very rapid onset, has no early subtle symptoms, and after it starts there is no way (with medications or an operation) to stop its progress. A common mistake is that usually patients with pancreatitis are managed by general internists, but not gastroenterologists or surgeons specialized in the pancreas. This cannot be overemphasized, since the modern management of pancreatitis is very different than 10, or even 5 years ago, and keeps evolving. The most common cause of pancreatitis is stones, or sludge in the gallbladder (“cholelithiasis”). A small stone, or sludge may slip out of the gallbladder, travel through the tube that connects it with the first part of the intestine (the duodenum), which passes through the pancreas, and block the tube at this particular location. This blockage builds the pressure inside the tube of the pancreas (the pancreatic duct) and causes inflammation of the pancreas. This is why small stones and sludge, instead of larger stones, are more likely to cause pancreatitis. Management of pancreatitis depends on its severity. Most patients suffer from a mild type of pancreatitis, which requires stay in the hospital for a few days, intravenous fluids, and removal of the gallbladder before they are discharged from the hospital. Before this laparoscopic cholecystectomy, the surgeon should make absolutely sure that the stone which blocked the duct and caused pancreatitis has now cleared from the tube. However, it is not uncommon that in some cases pancreatitis can be really severe, requiring Intensive Care Unit because the pancreas has an inflammation so severe that has evolved to “necrosis” (dying-off of the pancreas). This is a very critical condition, since it carries mortality up to 40%. For the latter condition it is absolutely essential that such patients are treated by a doctor who is truly an expert on complex pancreatic disease, and can administer the appropriate medical management and be qualified to make a judgment on whether and when an individual patient may need an operation.