{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:36:00Z","timestamp":1792683360806,"version":"4.5.0"},"reference-count":82,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Acute cholecystitis (AC) is a common surgical emergency. Recent evidence suggests that serum procalcitonin (PCT) is superior to leukocytosis and serum C-reactive protein in the diagnosis and severity stratification of acute infections. This review evaluates the role of PCT in AC diagnosis, severity stratification, and management. Materials and Methods: PubMed, Embase, and Scopus were searched from inception till 21 August 2022 for studies reporting the role of PCT in AC. A qualitative analysis of the existing literature was conducted. Results: Five articles, including 688 patients, were included. PCT \u2264 0.52 ng\/mL had fair discriminative ability (Area under the curve (AUC) 0.721, p &lt; 0.001) to differentiate Grade 1 from Grade 2\u20133 AC, and PCT &gt; 0.8 ng\/mL had good discriminatory ability to differentiate Grade 3 from 1\u20132 AC (AUC 0.813, p &lt; 0.001). PCT cut-off \u2265 1.50 ng\/mL predicted difficult laparoscopic cholecystectomy (sensitivity 91.3%, specificity 76.8%). The incidence of open conversion was higher with PCT \u2265 1 ng\/mL (32.4% vs. 14.6%, p = 0.013). A PCT value of &gt;0.09 ng\/mL could predict major complications (defined as open conversion, mechanical ventilation, and death). Conclusions: Current evidence is plagued by the heterogeneity of small sample studies. Though PCT has some role in assessing severity and predicting difficult cholecystectomy, and postoperative complications in AC patients, more evidence is necessary to validate its use.<\/jats:p>","DOI":"10.3390\/medicina59040805","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T03:01:48Z","timestamp":1682046108000},"page":"805","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Should Procalcitonin Be Included in Acute Cholecystitis Guidelines? A Systematic Review"],"prefix":"10.3390","volume":"59","author":[{"given":"Clyve Yu Leon","family":"Yaow","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7011-8624","authenticated-orcid":false,"given":"Ryan Ian Houe","family":"Chong","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9533-801X","authenticated-orcid":false,"given":"Kai Siang","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Tan Tock Seng Hospital, Singapore 637551, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Tze Wei","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore 637551, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-8142","authenticated-orcid":false,"given":"Vishal G.","family":"Shelat","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Department of General Surgery, Tan Tock Seng Hospital, Singapore 637551, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/jhbp.515","article-title":"Tokyo Guidelines 2018: Diagnostic Criteria and Severity Grading of Acute Cholecystitis (with Videos)","volume":"25","author":"Yokoe","year":"2018","journal-title":"J. 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