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To investigate the feasibility of endoscopic ablation of the gallbladder mucosa after cholecystostomy.The mucosa of the gallbladder was endoscopically electrocoagulated through the cholecystostomy tract. After ablation, repeated luminal irrigation with chymotrypsin solution was given before removal of the tube. The patients were followed up by ultrasonography after the procedure.Twenty patients accepted this operation. The mean operating time was 38 minutes (range, 25 to 55 min). There were no procedure-related mortality and complications including perforation, bleeding, and cholangitis. Eighteen gallbladders have completely obliterated in 3 months. The other 2 gallbladders developed asymptomatic retention cysts. During 48 months of follow-up period, no stone occurred and no signs of malignancy were found at the site of the gallbladder. Seven patients died from the other medical illness.Resectoscopic ablation of the gallbladder mucosa is a safe and promising approach to sclerosis of the gallbladder after cholecystostomy.