Vetshev P.S., Chilingaridi K.E., Ippolitov L.I., Shpachenko F.A. Moscow The article presents the analyzed case histories and studied the remote outcomes of 168 patients who underwent minicholecystectomy with elements of open laparoscopic technique (MCE). In 97.6% of cases, surgical intervention was performed for chronic calculous cholecystitis, in 4 observations, emergency cholecystectomy for acute calculous phlegmonous cholecystitis was performed within 72 hours. The average age of patients was 60.3±4.4 years. Combined surgeries were performed in 8.1%. The average incision length during MCE was 3.8±0.4 cm. The average operative time was 44.6±3.5 minutes, in uncomplicated cases the operative time decreases, averaging 21.3±4.8 minutes. Intraoperative complications were observed in 1.78%, including 2 cases of bleeding (1.19%), 1 parietal injury of the common bile duct (0.59%). In our observations, there was not a single case of conversion (transition to the traditional technique of cholecystectomy), no cases of postoperative wound suppuration, eventrations, or postoperative hernias were noted. In one case, during removal of a "porcelain bladder" measuring 18 ? 12 ? 10 cm, after completion of the main stages of the operation, the surgical incision was increased by 3.0 cm to extract the gallbladder. In case of choledocholithiasis, choledocholithotomy and drainage of the common bile duct according to Kehr were performed in 2 cases. In the early postoperative period, pain relief with narcotic analgesics was not performed in 98.5% of cases. Ketonal (ketoprofen) 100 mg was used. Intramuscularly 1-2 times during the first 24 hours. From the second day, patients were usually transferred to oral medication. The degree of analgesia in the early postoperative period was assessed using the method of E.M. Levit. The degree of analgesia in the overwhelming majority of cases was at least 4 points, which is characterized by moderate pain in the area of ??the postoperative wound during movement and coughing, but no pain at rest. The postoperative hospital stay of patients averaged 4.1 ± 0.4 days, when performing MCE without drainage of the common bile duct, as well as in cases where surgical treatment was performed only for cholelithiasis (not combined operations) - 2.1 ± 0.3 days. Changes in the function of external respiration in the early postoperative period, in particular the vital capacity of the lungs (VC), in patients who underwent MCE and LCE are significantly less pronounced compared to those in patients after traditional cholecystectomy (TCE). The vital capacity (VC) averages 70-80% of the baseline after MCE and LCE, and 50-60% after TCE. To study the quality of life of patients who underwent MCE, we tested them using the method developed in the Physico-Cholecystectomy Clinical Hospital (PCHK), calculating the so-called quality of life index (QLI) of the PCHK. Remote results were studied over periods from 6 months to 3 years. A control group of patients who underwent TCE and LCE (100 patients in each group) was selected for comparison. The hypothetical range of the final score can fluctuate from 0 to 135 conventional units. The QLI of patients who underwent MCE averaged 129.56±3.17 conventional units, which is significantly higher than in the group of patients who underwent traditional cholecystectomy (95.51±9.17 conventional units) (p<0.05) and comparable with the data obtained after LCE. Thus, MCE is a modern, high-tech method that adheres to the basic principles of surgical treatment of gallstone disease. In acute cholecystitis, MCE can be performed with maximum safety within 72 hours from the onset of the disease. In choledocholithiasis, surgical intervention can be performed using techniques similar to traditional surgery and completed with any option of external or internal drainage. Short-term and long-term results are similar to those after LCE. Calculating the ICC allows us to draw an objective conclusion about the more rapid return of patients who have undergone MCE to their usual social and intellectual activities. The accumulated ten years of experience have allowed us to definitively determine the place of this technique in surgical practice. For small abscesses (up to 50 ml), a good sanitation effect is achieved using single or multiple fine-needle punctures. Drainage with stylet catheters was used in only 2.3% of cases. For large abscesses (more than 50 ml), primary drainage is necessary. Currently, ultrasound-guided puncture procedures for abdominal abscesses can be considered an alternative to traditional surgery. Over the past five years, not a single targeted procedure has been performed for abscesses of this type, regardless of their origin or size. The widespread introduction of closed ultrasound-guided debridement into routine practice and improvements in the technique have allowed us to abandon the surgical treatment of intra-abdominal abscesses. No cases of bleeding, intestinal fistulas, or other complications that complicate the postoperative period with traditional treatment of abdominal abscesses have been observed with percutaneous treatment. Moreover, the overall mortality rate has decreased almost sevenfold (to 3.4%) compared to traditional debridement methods. Early patient mobilization after percutaneous drainage helps reduce the hospital stay to 13.4 days. Patients are monitored dynamically using ultrasonography and X-ray fistulography. The drainage tube is removed after confirmation of cavity wall collapse. Percutaneous debridement of postoperative abdominal abscesses can now be considered the method of choice in routine surgical practice. Its relative simplicity and accessibility in high-risk patients make it suitable for widespread implementation.