Hi, The decision to proceed with cholecystectomy in cases of acalculous cholecystitis with a low ejection fraction on the HIDA scan depends on the severity and frequency of symptoms, the patient s overall health, and the potential risks and benefits of surgery. A low ejection fraction on the HIDA scan indicates poor gallbladder function, and in cases of symptomatic acalculous cholecystitis, cholecystectomy is typically recommended. Although the symptoms may have improved, the underlying gallbladder dysfunction may persist and could lead to recurrent episodes of acalculous cholecystitis. Additionally, there is a risk of developing complications such as gallbladder perforation or infection, which can be life-threatening. It is not common for the ejection fraction to improve on its own, and delaying surgery may lead to worsening symptoms and complications. Therefore, it is important to discuss the risks and benefits of cholecystectomy with your healthcare provider and make an informed decision based on your circumstances. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician