Relevance. At the present stage of development of on-cology, the level of locally advanced and metastatic can-cer of the stomach is high, in total according to 2017 year stage III and IV were diagnosed with 63.7% of all newly diagnosed cases of gastric cancer. The surgical method is basic in the treatment of stomach cancer. Complications of the surgical treatment of gastric cancer, leading to the impossibility or delay of adjuvant treatment, significantly worsen the rates of relapse-free and overall survival. Due to the large difference in the frequency of complications (from 9% to 32%) with surgical aids, the development of combined methods for their treatment is relevant. Ob-jective. In this clinical case, demonstrated a stepwise ap-proach in the treatment of postoperative complications of gastrectomy using conservative and active surgical meth-ods, including minimally invasive endoscopic technolo-gies. Research materials. A case study of the treatment of complications of combined gastrectomy using a variety of approaches is presented. Research methods. Evalua-tion of treatment tactics for postoperative complications of gastrectomy using conservative, endoscopic and active surgical approaches, in comparison with published data. Results. Using a wide arsenal of therapeutic measures, it was possible to stop severe complications after gastrecto-my. Conclusion. Surgical tactics using minimally invasive technologies in combination with intensive care made it possible to timely eliminate the purulent-septic compli-cations. This clinical case demonstrates the applicability of the simultaneous and sequential use of conservative treatment, active surgical tactics and minimally invasive endoscopic technologies in the treatment of severe com-plications of gastrectomy. The choice of tactics in each specific case of the development of postoperative com-plications should be individual, while the use of only con-servative treatment is associated with less efficiency and greater mortality compared to the combined approach.