The study was based on 116 patients with mechanical jaundice of benign genesis, complicated by purulent cholangitis. In 35 patients with cholemic endotoxicosis after preliminary minimally invasive decompression of the biliary tract, various methods of treatment were used. In 11 patients (group I), traditional treatment including infusion and antibiotic therapy was used; in 12 patients (group II), plasmapheresis was used in combination with indirect electrochemical oxygenation (IECO) of plasma with sodium hypochlorite; and in 12 (group III) with additional plasma ozonation (PA with IECO + Ozone) and subsequent reinfusion of detoxified plasma. The developed differentiated stage-by-stage surgical tactics with the implementation of minimally invasive decompressions and the use of plasmapheresis allows to stop the phenomena of endotoxicosis, cholestasis and liver dysfunction and thereby improve the results of treatment of patients with acute cholangitis.