This 58 year old patient with history of hypertension, diabetes mellitus II, hyperlipidemia and renal failure on HD was admitted for increasingly purulent color and worsening odor through cholecystostomy tube placed 2 weeks prior in the setting of an unstable septic patient with an acute cholecystitis. CT scan showed distended GB (gallbladder) with wall thickening and a complex fluid collection containing air along the PCT tract, suspicious for abscess. Initially, diagnostic laparoscopy showed a dilated gallbladder with adhesions to omentum. After the PCT was removed, the GB was opened and a large amount of pus (~50cc) and stones were removed. The GB neck was fused to duodenum and transverse colon, cystic duct and artery were not identified. At this point decision was made to perform a partial cholecystectomy, removing the anterior wall of the GB. A cholangiogram was obtained from inside the Hartmann's pouch confirming location of the cystic duct and 2 interrupted stitches were placed over the cystic duct internally, fibrine glue was applied. Finally thorough abdominal washout was done and a JP drain was placed in the surgical bed. Patient was kept intubated and transferred to ICU on vasoconstrictors. On Postoperatory Day (POD) 2, patient stabilized and a small bile leak through the JP drain (40 cc/24hr) triggered the performance of an ERCP and stent placement. She was extubated on POD3 and discharged in POD5 with oral antibiotics. In POD7 JP drain was removed in clinic. Patient was followed up doing well 2 months after surgery.