According to the literature, modern data on the etiology, pathogenesis, clinic, diagnosis, treatment and prevention of acute cholangitis and biliary sepsis are analyzed in the complication of cholelithiasis. Acute purulent cholangitis and biliary sepsis are different manifestations of the infectious and inflammatory process that occurs locally and systemically. Postoperative lethality ranges from 13 to 60%. Many issues of pathogenesis, treatment and prevention of these pathological processes are not completely resolved and need further study.