Management of acute cholecystitis with concomitant liver abscess

Acute cholecystitis (AC) causes various complications including gangrenous cholecystitis, bacteriobilia, perforation and emphysematous chole-cystitis. The etiologies of pyogenic liver abscess (PLA) have shifted from intra-abdominal infections (such as acute appendicitis and trauma) to pathologic conditions of the biliary tract such as cholangitis and cholecystitis. Although PLA could be caused by AC, cases about acute chole-cystitis with concomitant liver abscess were rarely reported. Here, we reported four cases of AC with concomitant liver abscess, and laparoscopic cholecystectomy and liver abscess incision drainage were performed in all cases. The indication of concurrent laparoscopic cholecystectomy and liver abscess incision drainage is the operational choice in case of AC with concomitant PLA, located on the surface of the liver.