Sanaiha Y, Juo YY, Rudasill SE, et al. - Researchers performed a retrospective cohort study of 358,624 patients with non-elective admissions for acute cholecystitis (adults ≥ 65 years) with evidence of end-organ dysfunction (grade 3) in order to assess the mortality, morbidity, and readmissions associated with management of grade 3 cholecystitis in the elderly, vulnerable population. Of these, 14.9% underwent percutaneous cholecystostomy (PC), 15.7% open cholecystectomy (OC), and 69.4% laparoscopic cholecystectomy (LC). They observed a significant increase in the rate of PC from 2010-2015. Relative to OC and LC, PC had higher odds of mortality, morbidity, and readmission. Further, there was an association of PC with increased length of stay compared to LC. These findings emphasize performing revaluation of criteria for cholecystostomy at the initial presentation.