Two recent cases of acute cholecystitis without gallstones following gastrectomy are reported. Details of the cases are described and the rare nature of this postoperative complication emphasized. Clinical diagnosis is difficult and the cause of this complication is usually not ascertained. Cholecystectomy remain the basic treatment, of choice, but cholecystotomy or simple drainage may be the only possible therapy, and should be employed whenever necessary. Postoperative acute cholecystitis is rarely observed, is usually associated with gallstones, and occurs in patients with previously healthy gallbladders in only exceptional cases, usually following digestive tract operations (Thomoret and Bronstein, 9). The initial surgical intervention then involves the stomach, whether it be a gastrectomy or vagotomy (Champeau, Delattre, 2). Two recent cases of post-gastrectomy acute cholecystitis without gallstones led to a review of the published literature to determine the frequency of this complication, and an attempt to define its characteristics.