The risk of developing a stricture of the formed biliodigestive anastomosis is estimated in the range from 4.1 % to 69 % and the formation period from 11 to 30 months. Endoscopic techniques (incision, balloon   dilation, stenting) form the basis of the modern approach to the treatment of benign strictures of biliary anastomoses. If endoscopic assistance is unsuccessful or impossible, percutaneous X-ray surgical techniques of internal or external biliary drainage, balloon dilation and stenting are used. The aim of this study was to evaluate the safety, immediate efficacy and risk of recurrence of biliodigestive anastomosis stricture during its antegrade X-ray surgical correction with resolution of concomitant cholelithiasis. The study group included 16 patients with biliodigestive anastomotic strictures complicated by cholelithiasis. The control group included 42 patients with biliodigestive anastomotic strictures without concomitant cholelithiasis. The patients underwent antegrade balloon reconstruction of the stricture with drainage being brought down beyond the anastomosis zone and retained as a stent for at least 9 months. During the observation period (up to five years), recurrence of stricture requiring repeated X-ray surgical intervention occurred in five cases (11.9 %) in the control group (n = 42) and in 9 cases (56.3 %) in the study group (n = 16). To assess the reliability of differences in the treatment results of patients in both groups, nonparametric statistics methods were used. The risk of stricture recurrence during five years of observation in patients with concomitant cholelithiasis was significantly higher. Percutaneous transhepatic removal of cholelithiasis associated with scar stricture of the biliodigestive anastomosis using the technique of antegrade contact lithotripsy and lithoextraction is justified and has virtually no alternative, primarily in patients with high surgical and anesthetic risk.