The results of multimodality treatment of patients with pancreonecrosis with the use of laparotomy, endoscopic and transcutaneous procedures are presented. Different surgical approaches should be used for strict indications without contraposition but complementing each other according to each specific case. Adequate miniinvasive sanation and drainage of fluid collections linked with minor surgical trauma was proved to be advantageous over conventional methods in early stage of the disease and localized purulent complications. Application of miniinvasive techniques along with conservative treatment for pancreonecrosis allows enhancing efficacy of detoxication, stabilizing patients’ condition and performs open surgeries under favorable auspices. Miniinvasive interventions for strict indications provide an opportunity to reduce number of complications and lethality, length of hospital stay, spending of dressing material, cut electrolyte and protein losses, preserve patients activity, avoid repeated anesthesia and postoperative hernias, obtain better cosmetic results.