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It is presented case report of a patient with multiple cholangiogenic abscesses of right liver lobe in 7 years after primary surgery. High efficiency of minimally invasive technologies for purulent complications of biliary surgery was emphasized. Moreover, it was confirmed that choledochoduodenostomy as a variant of internal biliary drainage is not desirable for complicated course of cholelithiasis.

Of 21 patient to whom after choledochotomy the external drainage of common bile duct was conducted, the suture insufficiency have occurred in 3, 2 patients died. After choledochoduodenostomy conduction the suture insufficiency was observed in 3 of 17 patients, 2 patients died. After papilloshincteroplasty conduction the complications were revealed in 5 of 23 patients, 3 patients died. Of 4 patients, in whom the twin internal drainage was conducted, 3 died.

The results of surgical treatment of 209 patients with diseases of bile ducts with use of minimum approach and special instrument are presented. Cholecystectomy was carried out in 186 patients, cholecystectomy together with other interventions-in 15, operations on hepaticocholedochus in 7, cholecystectomy and choledochostomy-in 1. Intraoperation surgical complications were observed in 0.95% of cases, postoperative ones--in 2.34%; postoperative mortality rate made up 0.95%. After cholecystectomy the patients were discharged in 3-9 days. The authors consider the operations on biliary tract from minimum approach as an alternative to conventional laparotomy as well as laparoscopic cholecystectomy.

Experience in repeated operations on the biliary tract in 51 patients is analysed. Endoscopic retrograde cholangiopancreatography is one of the informative methods. The choice of the method of operative treatment must be individualized according to the nature of the pathological process in the biliary system. An endoscopic intervention may be an alternative to surgical operations in many cases.

Questions concerned with the penetration of bile into the abdominal cavity are discussed. The observation of 9 patients was used. The effusion of infected bile into abdominal cavity results in the development of bile peritonitis requiring urgent surgical measures. If the bile is not infected, bile ascites is developing, its clinical picture being obliterated and the patients often remaining in satisfactory condition for a long time.