This chapter explores the complexities of cholecystectomy after percutaneous cholecystostomy tube for management of acute cholecystitis. Indications for and timing of PCT placement are covered, using the 2018 Tokyo Guidelines to stratify patients. Next we discuss outpatient management of cholecystostomy tubes and an algorithm for tube removal or interval cholecystectomy. We provide specific recommendations for timing of tube removal, timing of cholecystectomy, and clinical pitfalls that surgeons encounter in the management of these patients.
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