**11. Conclusions**

When an acalculous acute cholecystitis is suspected, the cholecystostomy must be carried out immediately, because the patient can only improve with this technique. If the improvement occurs with the decompression and drainage through cholecystostomy, the tube can be removed after 3 weeks, and this is the only treatment needed [36–39]. If there is no improvement, urgent cholecystectomy should be strongly considered as it can save the patient's life and thus improve abdominal sepsis [40–42].
