Acute cholecystitis (AC) appears as the basic complication of cholelithiasis. However, the leading place in the mortality structure belongs to choledocholithiasis, cholangitis obstructive, jaundice, and especially to infected biliary pancreatic necrosis. Retrospective analysis of the results of investigations and surgical treatment of 1023 patients with complicated forms of cholelithiasis included 314 men and 709 women at the age between 15 and 91 years. Such complications of cholelithiasis as AC, choledocholithiasis, cholangitis and stricture of papilla major are not the contra-indication to laparoscopic cholecystectomy. The treating possibilities of laparoscopic and endoscopic technique in 96.2% cases allowed successfully performing cholecystectomy and the correction of bile outflow without doing the wide laparotomy. Offered technical improvements of laparoscopic cholecystectomy promoted lowering of conversions number (from 8.8% to 3.8%) and the quantity of intra- and post-operative complications contained in the changes of trocat inserting points, using modified instruments for tissue dissection, mobilizing of gall-bladder and hemostasis
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