Acute cholelithiatic cholecystitis is usually treated with cholecystectomy or cholecystostomy, but the prognosis of the procedure for the disease is not known. A study by Anderson JE, from the Department of Surgery at the University of California, San Diego Hospital, suggests that cholecystostomy does not improve survival in patients with acute cholelithiasis with sepsis and shock. The article was recently published in the journal J SurgRes. A longitudinal analysis of patient discharge data from 1995 to 2009 from the California-wide Office of Health Planning and Development was conducted. The criteria for diagnosing acute cholelithiasis cholecystitis were ICD-9 (International Classification of Diseases, 9th Revision). Cox proportional risk analysis identified predictors of time to death after adjusting for patient demographic characteristics, sepsis, shock, frailty, charlson comorbidity index, length of hospital stay, type of insurance, hospital level, and length of illness. The results of the study showed that 63.5% of 43,341 patients underwent cholecystectomy, 2.8% underwent cholecystostomy, and 1.2% underwent cholecystectomy combined with cholecystostomy. The overall mortality rate was 30.4%, with a postoperative mortality rate of 23% for cholecystectomy, 61.7% for cholecystostomy, and 42% for no intervention. Although cholecystectomy (with or without combined cholecystostomy) has been shown to improve survival, cholecystostomy in patients with sepsis and shock had no effect on survival. The results were similar in patients on ventilators for >96 hours. In this study, cholecystectomy was shown to improve survival in acute cholelithiasis; cholecystostomy did not improve survival in patients with severe sepsis and shock. Cholecystostomy should not be considered when the patient’s condition is not suitable for cholecystectomy.