85 year old male with acute cholecystitis and failed conservative management.
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1. Ultrasound image demonstrates a dilated gallbladder. Safe access for a direct transperitoneal gallbladder puncture is established.
2. Following gallbladder puncture, a guidewire has been inserted. Part of the guidewire (arrow) can be visualized within the gallbladder.
3. 8Fr pigtail drain (arrow) inserted over the guidewire. A small benign liver cyst is noted incidentally.
Ultrasound guided percutaneous cholecystostomy is a safe and effective procedure in high risk patients with severe acute cholecystitis.