Letter to the Editor: Timing matters in percutaneous cholecystostomy: Survival signals and unresolved catheter endpoints

doi:10.4240/wjgs.118795

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jun 27, 2026; 18(6): 118795
Published online Jun 27, 2026. doi: 10.4240/wjgs.118795

Letter to the Editor: Timing matters in percutaneous cholecystostomy: Survival signals and unresolved catheter endpoints

Guang-Bin Chen, Zhi-Lin Wang, Ke Wang, Guang-Ming Xu, Long-Jiang Chen, Yu-Zhi Hu

Guang-Bin Chen, Yu-Zhi Hu, Department of Hepato-Pancreato-Biliary Surgery, The Second People’s Hospital of Wuhu, Wuhu Hospital Affiliated to East China Normal University, Wuhu 241000, Anhui Province, China

Guang-Bin Chen, Zhi-Lin Wang, Ke Wang, Guang-Ming Xu, Graduate School, Wannan Medical College, Wuhu 241000, Anhui Province, China

Long-Jiang Chen, Department of Hepatobiliary Surgery, Affiliated Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui Province, China

Co-first authors: Guang-Bin Chen and Zhi-Lin Wang.

Co-corresponding authors: Long-Jiang Chen and Yu-Zhi Hu.

Author contributions: Chen GB and Wang ZL performed literature retrieval, wrote the original draft, and contributed equally to this work; Wang K and Xu GM performed literature retrieval; Chen LJ and Hu YZ contributed to conceptualization, writing, review, editing, and project administration, and they contributed equally as co-corresponding authors. All the authors approved the final manuscript. We respectfully designate Chen LJ and Hu YZ as co-corresponding authors for this manuscript, as both have made substantial and complementary contributions that warrant shared corresponding authorship in accordance with ICMJE criteria. Chen LJ (MD, PhD, Department of Hepatobiliary Surgery, Affiliated Yijishan Hospital of Wannan Medical College) provided critical oversight from the surgical perspective, contributing extensive clinical expertise in managing complex cholecystitis cases and guiding the interpretation of patient outcomes, catheter management strategies, and surgical decision-making discussed throughout the manuscript. His insights were instrumental in contextualizing the clinical implications of timing and post-procedural care pathways, particularly regarding the transition from acute stabilization to definitive surgical intervention. Hu YZ (MD, Chief Physician, Department of Hepato-Pancreato-Biliary Surgery, The Second People’s Hospital of Wuhu, Wuhu Hospital Affiliated to East China Normal University) contributed valuable expertise in hepato-pancreato-biliary surgery and evidence-based clinical practice, offering technical perspectives on percutaneous cholecystostomy techniques, procedure-related complications, multidisciplinary management approaches, and evidence synthesis. He played a key role in structuring the manuscript’s argumentative framework and ensuring alignment with contemporary guideline recommendations, including the Tokyo Guidelines, World Society of Emergency Surgery guidelines, and source control consensus statements. Both authors collaboratively supervised the manuscript development across all stages, provided critical intellectual input on study conceptualization and clinical interpretation, critically revised the content for important academic and clinical accuracy, approved the final version, and accept full accountability for all aspects of the work. Their complementary expertise-bridging hepatobiliary surgery, interventional management, and guideline-based practice-strengthens the multidisciplinary perspective essential to addressing the complex clinical endpoints discussed in this article.

Conflict-of-interest statement: The authors declare no conflicts of interest.

Corresponding author: Yu-Zhi Hu, MD, Chief Physician, Department of Hepato-Pancreato-Biliary Surgery, The Second People’s Hospital of Wuhu, Wuhu Hospital Affiliated to East China Normal University, No. 6 Du Chun Road, Jinghu District, Wuhu 241000, Anhui Province, China. huyuzhisci@163.com

Received: January 12, 2026
Revised: January 22, 2026
Accepted: February 6, 2026
Published online: June 27, 2026
Processing time: 155 Days and 11.9 Hours

Core Tip

Core Tip: Early percutaneous cholecystostomy (PC) improves short-term survival in high-risk patients with acute cholecystitis; however, survival alone may not capture the full spectrum of post-procedural outcomes. This commentary highlights the disconnection between early life-saving interventions and unresolved downstream endpoints, including prolonged catheter dependence and low definitive cholecystectomy rates. By emphasizing the importance of timing alongside a structured post-PC reassessment, we argue that standardized patient-centered management pathways are essential for translating early survival benefits into durable clinical outcomes.