Q: For acalculous cholecystitis all of the following are part of treatment except ?

A)  open or laparoscopic cholecystectomy

B) endoscopic gallbladder stent placement

C)  antibiotics

D) percutaneous cholecystostomy

E) Observation

Answer: E

Acalculous cholecystitis requires immediate intervention due to high risk of gallbladder perforation.

In stable patients open or laparoscopic cholecystectomy is preferred. In non-surgical patients, endoscopic gallbladder stent placement of a double pigtail stent between the gallbladder and the duodenum via ERCP can be effective. Other option in non-operable patients is antibiotics with percutaneous cholecystostomy. If patient is unstable for any procedure, at least antibiotics should be given.