{
  "abstract": "Background: Procalcitonin (PCT) may support decision-making in abdominal and emergency surgery when infection is difficult to distinguish from non-infectious inflammation. Its interpretation remains challenging because clinical settings, sampling schedules, and proposed thresholds vary. This WSES position paper examines the evidence across six clinical scenarios to provide a practical framework for PCT-informed decision-making. Methods: A structured literature review covering January 1980 to December 2025, with targeted updates through August 2026, informed six PICO-based clinical questions. Evidence appraisal drew on selected GRADE domains, including consistency, directness, and precision. Recommendations were developed through iterative expert review and consensus. Results: The panel formulated six conditional recommendations addressing intra-abdominal infection diagnosis, antibiotic discontinuation after source control, suspected source-control failure, infected pancreatic necrosis, infectious complications after trauma, and postoperative anastomotic leak. The panel's qualitative assessment rated evidence certainty as moderate for antibiotic discontinuation and the pancreatitis domain, and low for the remaining domains. Serial PCT trends may complement clinical assessment in selected patients. Evidence for reduced antibiotic exposure with predefined PCT algorithms is more established than evidence that PCT-informed imaging, reintervention, or discharge decisions improve patient outcomes. Conclusions: PCT-informed decision-making in abdominal surgery may contribute to a more individualized approach to emergency surgical care and precision emergency surgery. When interpreted as part of serial assessment and integrated with clinical judgement, organ-dysfunction trends, microbiology, imaging, and evaluation of source-control adequacy, PCT may support individualized antibiotic discontinuation, potentially earlier recognition of an unfavourable clinical course, and more timely diagnostic and source-control reassessment. Current evidence does not support universal thresholds or routine serial testing in all surgical patients. Biomarker kinetics should strengthen, but not replace, surgical reasoning or independently determine antimicrobial, imaging, or interventional decisions. Future research should validate setting-specific thresholds and sampling schedules, establish whether PCT provides actionable information before clinical deterioration, and evaluate the clinical effects and cost-effectiveness of PCT-informed pathways.",
  "abstract_shown": true,
  "affiliations": [
    "World Society of Emergency Surgery, Institute for Research in Emergency General Surgery (IREGS), Via Cracovia 23, 40139 Bologna, Italy.",
    "Department of Emergency and General Minimally Invasive Surgery, Level I Trauma Center, Bufalini Hospital, AUSL Romagna, Viale Ghirotti 286, 47521 Cesena, Italy.",
    "Department of Theoretical and Applied Sciences, eCampus University, Novedrate, 22060 Como, Italy.",
    "Department of Surgery No. 2, Kharkiv National Medical University, 61022 Kharkiv, Ukraine.",
    "Department of General Surgery, Madonna del Soccorso Hospital, 63074 San Benedetto del Tronto, Italy.",
    "Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.",
    "R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA.",
    "Trauma and Burns Service, Department of Surgery, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban 4013, South Africa.",
    "Inkosi Albert Luthuli Central Hospital, Durban 4091, South Africa.",
    "Department of General Surgery, School of Medicine, Istanbul Medeniyet University, 34700 Istanbul, Türkiye.",
    "Fourth Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.",
    "George Papanikolaou General Hospital, 54124 Thessaloniki, Greece.",
    "Department of Surgical Sciences, University of Cagliari, 09042 Cagliari, Italy.",
    "Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.",
    "Division of General Surgery, University Hospital Maggiore della Carità, 28100 Novara, Italy.",
    "Department of Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada.",
    "Department of Hepatobiliary and Pancreatic Surgery, Trauma and Acute Care Surgery, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada.",
    "Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden.",
    "Department of Surgery, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden.",
    "Trauma, Emergency and Abdominal Wall Unit, Hospital Dr. Sótero del Río, Av Concha y Toro 3459, Puente Alto Santiago 8150215, Chile.",
    "Department of Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea.",
    "Department of Urology, AdventHealth Riverview, Riverview, FL 33878, USA.",
    "Department of General Surgery, Anadolu Medical Center Hospital, 41400 Kocaeli, Türkiye.",
    "Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore.",
    "Trauma Centre, Groote Schuur Hospital, Cape Town 7700, South Africa.",
    "Department of Surgery, University of Cape Town, Cape Town 7700, South Africa.",
    "Department of Surgery, University Hospital of Trauma, 1000 Tirana, Albania.",
    "Faculty of Medicine, University of Medicine, 1010 Tirana, Albania.",
    "Department of Surgery, Radboud University Medical Center, 6625 GA Nijmegen, The Netherlands.",
    "Venice School of Management, Ca' Foscari University of Venice, 30123 Venice, Italy.",
    "Collegium Medicum, SAN University, 90519 Łódź, Poland.",
    "Department of Traumatology, John Hunter Hospital, Newcastle, NSW 2308, Australia.",
    "School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia.",
    "Department of Surgical Sciences and Advanced Technologies, University of Catania, 95131 Catania, Italy.",
    "Cannizzaro Hospital, 95131 Catania, Italy.",
    "Department of Surgery, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China.",
    "Department of Surgery, Ewha Womans University College of Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Republic of Korea.",
    "Department of General Surgery, Royal Perth Hospital, Perth, WA 6000, Australia.",
    "University of Western Australia, Perth, WA 6009, Australia.",
    "Curtin University, Perth, WA 6845, Australia."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 66,
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    {
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  "bibtex": "https://research.draconitic.com/paper/4gw5222be8etj.bib",
  "cited_by": 0,
  "doi": "10.3390/antibiotics15101042",
  "fulltext_url": "https://europepmc.org/articles/PMC13700824",
  "id": "4gw5222be8etj",
  "issns": [
    "2079-6382"
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  "landing_url": "https://europepmc.org/article/MED/42938782",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Sepsis Diagnosis and Treatment"
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  "pdf_url": "https://europepmc.org/articles/PMC13700824?pdf=render",
  "pmcid": "PMC13700824",
  "pmid": "42938782",
  "published": "2026-10-21",
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  "ris": "https://research.draconitic.com/paper/4gw5222be8etj.ris",
  "sources": [
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      "first_seen": "2026-10-30T12:22:12Z",
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      "url": "https://europepmc.org/article/MED/42938782"
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  "subjects": [
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      "field": "medicine",
      "origin": "openalex:2713|Sepsis Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
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  ],
  "title": "Procalcitonin-Informed Decision-Making in Abdominal and Emergency Surgery: A WSES Position Paper.",
  "title_text": "Procalcitonin-Informed Decision-Making in Abdominal and Emergency Surgery: A WSES Position Paper.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:12Z",
  "url": "https://research.draconitic.com/paper/4gw5222be8etj",
  "venue": "Antibiotics (Basel, Switzerland)",
  "versions": []
}