Optimal timing of pyogenic liver abscess evacuation - The role of early ultrasound-guided intervention

Sep 28, 2026

Uploaded by Franzy

This editorial comments on Qiu et al.’s article, framing pyogenic liver abscess as a serious condition that demands timely, effective management. Ultrasound-guided minimally invasive drainage, including needle aspiration or catheter drainage, is emphasized as key—especially for multiple or deep abscesses. The piece argues that early evacuation, even when abscesses are partially or non-liquefied, is safe and effective, often improving symptom resolution and shortening hospitalization while reducing complications, compared with delayed traditional liquefaction.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

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| W | J | G | S | World Journal of
Gastrointestinal Surgery | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Surg 2025 December 27; 17(12): 110644 DOI: 10.4240/wjgs.v17.i12.110644 ISSN 1948-9366 (online) EDITORIAL Optimal timing of pyogenic liver abscess evacuation: The role of early ultrasound-guided intervention Enver Zerem, Predrag Jovanovic, Suad Kunosic, Admir Kurtcehajic, Dina Zerem, Omar Zerem Specialty type: Gastroenterology and hepatology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade A, Grade C Novelty: Grade A, Grade C Creativity or Innovation: Grade B, Grade C Scientific Significance: Grade B, Grade C P-Reviewer: Kanthlal S, Chief, Full Professor, India; Lomeli SM, PhD, Adjunct Associate Professor, Associate Research Scientist, Researcher, Mexico Received: June 12, 2025 Revised: June 29, 2025 Accepted: September 12, 2025 Published online: December 27, 2025 Processing time: 197 Days and 5.3 Hours Enver Zerem, Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo 71000, Bosnia and Herzegovina Enver Zerem, Suad Kunosic, Admir Kurtcehajic, BIOS Research Group Tuzla, Tuzla 75000, Bosnia and Herzegovina Predrag Jovanovic, Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Clinic for Internal Diseases, Tuzla 75000, Bosnia and Herzegovina Suad Kunosic, Department of Physics, Faculty of Natural Sciences and Mathematics, University of Tuzla, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina Admir Kurtcehajic, Department of Gastroenterology and Hepatology, Blue Medical Group, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina Dina Zerem, Omar Zerem, Department of Internal Medicine, Cantonal Hospital “Safet Mujić”Mostar, Mostar 88000, Bosnia and Herzegovina Corresponding author: Enver Zerem, MD, PhD, Full Professor, Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Bistrik 7, Sarajevo 71000, [Bosnia and Herzegovina.](Bosnia and Herzegovina. zerem@live.com)[ zerem@live.com](Bosnia and Herzegovina. zerem@live.com) Abstract In this editorial, we comment on the article published by Qiu et al. Pyogenic liver abscess is a serious clinical condition requiring timely and effective intervention. Ultrasound (US)-guided techniques-whether needle aspiration (NA) or catheter drainage-are key minimally invasive treatments, especially in patients with multiple or deep-seated abscesses where conventional surgery is often impractical. The timing and choice of evacuation method significantly influence clinical outcomes. Although catheter drainage may be necessary for larger or refractory collections, NA represents a less invasive alternative that is often sufficient for smaller abscesses-particularly multiloculated ones-and can avoid multiple catheter placements. This consideration is especially important in the early phase of the disease, when the abscess collection is poorly demarcated from surrounding tissue and more prone to bleeding during or after intervention. Traditional practice delays intervention until liquefaction occurs; however, emerging evidence supports early US-guided evacuation - even in partially liquefied or non-liquefied abscesses - as both safe and effective. Early intervention, particularly via NA when feasible, is associated with faster symptom WJGS [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 27, 2025 Volume 17 Issue 12 Zerem E et al. Early US-guided intervention in liver abscess resolution, shorter hospitalization, and fewer complications. This editorial explores the role of US-guided interventions in pyogenic liver abscess mana-ement, emphasizing the importance of individualized, timely approaches that optimize diseas

FAQs

Why is timely intervention important in pyogenic liver abscess?

The editorial states that pyogenic liver abscess requires timely and effective intervention to optimize outcomes and prevent complications. Early US-guided evacuation is positioned as especially beneficial in the early disease phase.

What ultrasound-guided drainage options are discussed?

The text highlights needle aspiration (NA) and catheter drainage (CD) as key minimally invasive treatments. It notes that NA is often sufficient for smaller or multiloculated abscesses.

How does early ultrasound-guided evacuation compare with delayed drainage?

The editorial contrasts traditional practice that delays intervention until liquefaction with emerging evidence supporting early evacuation. It reports associations with faster symptom resolution, shorter hospitalization, and fewer complications, while emphasizing individualized approaches.

Sep 28, 2026

Uploaded by Franzy