Objective. To improve the outcomes in patients with severe destructive pancreatitis undergoing minimally invasive surgery. Material and methods. There were 482 patients with acute destructive pancreatitis for the period from 2007 to 2016. Non-infected acute destructive pancreatitis was diagnosed in 58% (n=280) of patients, infected pancreatic necrosis — in 42% (n=202) of patients. Minimally invasive technologies were used in the treatment of purulent complications of destructive pancreatitis: endoscopic papillotomy, percutaneous puncture of fluid accumulations, ultrasound- and X-ray-assisted drainage of abscesses and retroperitoneal phlegmon. Results. There were 688 drainage surgeries in 92 patients with infected pancreatic necrosis: US-assisted Seldinger drainage — 599 (87%), single-stage drainage — 89 (13%) cases. Percutaneous transfistular retroperitoneal interventions were made in 72 patients (one intervention — 29 patients, redo procedures — 43 patients). Complications associated with minimally invasive procedures developed in 2.7% (19) of cases. Six patients required laparotomy. Mean length of hospital-stay was 36.5 days. Mean rate of restitution of post-necrotic areas was 37.7 days. Conclusion. Minimally invasive procedures reduce overall mortality up to 6% in patients with acute pancreatitis and up to 14% in those with destructive forms of inflammation.