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Unorthodox approach to management of Empyema Gallbladder during COVID pandemic in a developing country

Laparoscopic Cholecystectomy has established itself as the standard of care for treatment of gallstone disease. The management of high risk patients becomes challenging when they present in Emergency with complications of gallstone disease. These patients are generally elderly with multiple co-morbids; in particular cardiac patients with uncontrolled diabetes present late with acute cholecystitis and have systemic inflammation. The timing of surgery, extent of pre-operative optimization and use of laparoscopy for surgery continue to be utilized differently in such patients across the world especially in regard to COVID Pandemic. We report a case of elderly male with empyema gallbladder during first wave of COVID pandemic.