The prevalence of cholelithiasis, which affects 10-15% of men and has increased to 25% in women in industrialized countries, makes this pathology an urgent public health issue [1]. It is considered the primary cause of acute cholecystitis and associated complications in the vast majority of cases (95%), which emphasizes its importance. There are various opinions regarding the surgical strategy, especially in the acute phase of the disease. However, the widespread perception of acute cholecystitis as the only complication does not reflect the complexity of the picture: the disease can affect the complex "gall bladder - ducts - subgastric cholecystitis", causing a variety of disorders [7]. The key treatment method for purulent cholangitis is early surgical intervention aimed at external decompression of the biliary ducts using drains and removal of stones from the common duct [2]. This approach ensures the removal of infected biliary ducts, significantly reducing the degree of mechanical damage and toxic effects on the body.