['In high-risk patients with acute calculous cholecystitis (ACC), percutaneous cholecystostomy (PC) can serve as a bridging option to cholecystectomy [laparoscopic cholecystectomy (LC)] or as definitive treatment. The purpose of this study was to identify predictors of the need for permanent PC.', 'Data from 257 PCs performed for ACC (mean age 67.3\xa0±\xa014) was collected for a 10-year period. Demographic and clinical characteristics at initial admission, co-morbidities were analyzed. Patients who underwent interval LC were defined as the surgery group (SG; n\xa0=\xa0163, 63.4\xa0%) and the remaining patients as the non-SG (NSG; n\xa0=\xa094, 36.6\xa0%).', 'Patients in the SG were significantly younger and had a shorter length of hospital stay (p\xa0<\xa00.01). The rate of coronary artery disease (CAD; 63.2 vs. 20.2\xa0%), chronic renal failure (14.9 vs. 6.1\xa0%), and the mean number of co-morbidities (2.2 vs. 1.4) were significantly higher in the NSG. Sepsis at admission was more common in the NSG (19.1 vs. 4.9\xa0%, p\xa0<\xa00.001). 56 patients (34.4\xa0%) in the SG and 24 patients (25.5\xa0%) in the NSG developed tube-related complications. In hospital mortality was similar between the groups. Multivariate analysis showed that age ≥75, increased alkaline phosphatase (ALK-P), history of CAD, were predictors of PC as a definite treatment in this high-risk group of patients with ACC.'] Is percutaneous cholecystostomy safe and effective option for acute calculous cholecystitis in select group of high-risk patients?