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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2025; 17(12): 110644
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.110644
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.110644
Optimal timing of pyogenic liver abscess evacuation: The role of early ultrasound-guided intervention
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
Author contributions: Zerem E contributed to manuscript conception and design; Jovanovic P, Kunosic S, Kurtcehajic A, Zerem D, and Zerem O contributed to the literature search; Zerem E, Jovanovic P, Kunosic S, Kurtcehajic A, Zerem D, and Zerem O wrote the paper. All authors approved final revision of the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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. zerem@live.com
Received: June 12, 2025
Revised: June 29, 2025
Accepted: September 12, 2025
Published online: December 27, 2025
Processing time: 197 Days and 0.6 Hours
Revised: June 29, 2025
Accepted: September 12, 2025
Published online: December 27, 2025
Processing time: 197 Days and 0.6 Hours
Core Tip
Core Tip: Timely and individualized treatment of pyogenic liver abscess is essential for optimal outcomes and complication prevention. This editorial highlighted ultrasound (US)-guided procedures as safe, effective, and minimally invasive therapeutic strategies. Emerging evidence supports early US-guided interventions - even in partially or non-liquefied abscesses - challenging the traditional preference for delayed drainage. Needle aspiration is particularly suited for smaller or multiloculated abscesses, as it avoids unnecessary catheter placement and reduces procedural risks. Tailoring US-guided interventions to abscess characteristics and the patient’s clinical status is key to successful management of pyogenic liver abscess.