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Percutaneous cholecystostomy can be a useful technique for the ill, elderly, or high-risk patient, since he or she is spared open surgery. We used it successfully in a medically unstable woman with acute acalculous cholecystitis. Her drainage catheter, often the source of complications with the procedure, may have been removed too early: A small asymptomatic subdiaphragmatic fluid collection and ileus developed. However, both resolved in 48 hours.