{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:19:37Z","timestamp":1791371977256,"version":"4.3.1"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T00:00:00Z","timestamp":1712361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Laparoscopic subtotal cholecystectomy (LSC) is a safe alternative for difficult cholecystectomies to prevent bile duct injury and open conversion. The primary aim was to detail the use and outcomes on LSCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of a prospectively maintained database of laparoscopic cholecystectomy (LC). Relative clinical factors, outcomes, and 30\u2010day follow\u2010up between LSC and LC were compared using univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six hundred and twenty four cholecystectomies were performed and 53 (8.5%) required LSC. 81.8% were fenestrating LSC. Male sex was significantly overrepresented in the LSC group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and patients requiring LSC were significantly older (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Same admission cholecystectomy was associated with a higher risk of LSC (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Patients with a history of previous surgery, preoperative ERCP, or percutaneous cholecystostomy had an increased risk of undergoing LSC (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). A necrotic gallbladder was the most significant predictor of the need for a LSC (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). A contracted gallbladder, extensive adhesions, gallbladder empyema, and severe inflammation were significant predictors of difficulty (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Postoperative complications occurred in 26.4% of LSC patients. There were ten (18.9%) Clavien\u2013Dindo Grade III complications, 5.7% required ERCPs, and 9.4% required relook laparotomies. Significantly, more patients in the LSC group developed bile leaks (<jats:italic>n<\/jats:italic>\u00a0=\u00a08, 15%) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). There were two readmissions within 30\u00a0days, one mortality, and no BDIs occurred in the LSC cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LSC provides a feasible surgical option that should be utilized in complex cholecystitis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12180","type":"journal-article","created":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T12:39:36Z","timestamp":1712407176000},"page":"1323-1330","source":"Crossref","is-referenced-by-count":5,"title":["Laparoscopic subtotal cholecystectomy outcomes across a low\u2010and middle\u2010income country metropolitan health service"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4829-2511","authenticated-orcid":false,"given":"Karien","family":"Booyse","sequence":"first","affiliation":[{"name":"Division of General Surgery University of Cape Town Health Sciences Faculty and Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8089-0191","authenticated-orcid":false,"given":"Jessica","family":"Lindemann","sequence":"additional","affiliation":[{"name":"Division of General Surgery University of Cape Town Health Sciences Faculty and Groote Schuur Hospital  Cape Town South Africa"},{"name":"Department of Surgery Washington University School of Medicine  Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1737-8091","authenticated-orcid":false,"given":"Mariska","family":"Calitz","sequence":"additional","affiliation":[{"name":"Division of General Surgery University of Cape Town Health Sciences Faculty and Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-8548","authenticated-orcid":false,"given":"Marc","family":"Bernon","sequence":"additional","affiliation":[{"name":"Division of General Surgery University of Cape Town Health Sciences Faculty and Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-256X","authenticated-orcid":false,"given":"Eduard","family":"Jonas","sequence":"additional","affiliation":[{"name":"Division of General Surgery University of Cape Town Health Sciences Faculty and Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-6879","authenticated-orcid":false,"given":"Christo","family":"Kloppers","sequence":"additional","affiliation":[{"name":"Division of General Surgery University of Cape Town Health Sciences Faculty and Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199104183241601"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002\u20109610(05)80397\u20106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199106000\u201000018"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199904000\u201000001"},{"issue":"4","key":"e_1_2_11_6_1","first-page":"491","article-title":"Has Laparoscopic Cholecystectomy Changed Patterns of Practice and Patient Outcome in Ontario?","volume":"154","author":"Cohen M. 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