Laparoscopic management of a cholecystocutaneous abscess.

Spontaneous cholecystocutaneous abscess or fistula is a rare complication of gallbladder disease that has been known since the time of Thilesus in 1670. We describe the case of a 72-year-old white woman who presented with a large subcutaneous abscess in the right upper quadrant of the abdomen accompanied by fever and leukocytosis. There was no history of diabetes or trauma. An abdominal CT scan revealed communication of the abscess cavity with the gallbladder. Laparoscopic cholecystectomy followed by open drainage of the abdominal wall abscess were accomplished without complication. Traditional treatment for a cholecystocutaneous abscess has consisted of abdominal wall incision and drainage followed by staged cholecystectomy. One-stage treatment of the cholecystocutaneous abscess is a preferred option, and a laparoscopic approach appears feasible.