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To evaluate the efficacy, long-term outcome, and safety of percutaneous cholecystostomy (PC) in high-risk surgical patients.This was a retrospective descriptive review of the medical records of 36 patients who underwent PC for acute cholecystitis (AC) at a single institution between 2000 and 2011. Primary outcomes were overall morbidity, mortality, and need for interval cholecystectomy.PC was initially successful, and symptoms disappeared within 3 days in all patients. Seven patients (2 during hospitalization and 5 during follow-up) died, 6 for a reason unrelated to AC, and 1 succumbed to a sepsis-related condition caused by uncontrolled cholecystitis progression. Elective cholecystectomy was performed in 6 patients. PC was a definitive treatment in 63.9% of patients.PC is a safe and efficient treatment option for patients with AC who are less eligible for surgery. After patients recover from PC, further treatment such as cholecystectomy may not be needed.