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Patients with acute calculous cholecystitis are usually undertaken surgery laparoscopic cholecystectomy.However,there are controversies about the decision of operation for patients with high risk factors.Percutaneous transhepatic gallbladder drainage (PTGD) is palliative therapy to alleviate symptoms and physical signs.Since improved clinical outcome has been observed for PTGD,it was recommended as an initial therapeutic option for high risk patients who might need surgery.1 Percutaneous drainage in acute calculous cholecystitis for high risk patients is to be a safe and successful treatment option for patients less eligible for surgery.2 PTGD is relatively safe,but has certain complications.We provided a case report of acute calculous cholecystitis associated with hepatic artery pseudoaneurysm after PTGD in a diabetes mellitus patient.The liver vascular pseudoaneurysms and secondary changes of liver were documented by the imaging examination.The complex interactions among inflammation,bleeding,and diabetes mellitus were involved in this case.