{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:19:40Z","timestamp":1791371980727,"version":"4.3.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"funder":[{"name":"SPORE Grant","award":["CA196510"],"award-info":[{"award-number":["CA196510"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2021,7]]},"DOI":"10.1007\/s00464-020-07759-2","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T16:03:30Z","timestamp":1593446610000},"page":"3249-3257","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Less is more in the difficult gallbladder: recent evolution of subtotal cholecystectomy in a single HPB unit"],"prefix":"10.1007","volume":"35","author":[{"given":"Michael T.","family":"LeCompte","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keenan J.","family":"Robbins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg A.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic E.","family":"Sanford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chet W.","family":"Hammill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"Fields","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G.","family":"Hawkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Strasberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,29]]},"reference":[{"key":"7759_CR1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1002\/jhbp.616","volume":"26","author":"SM Strasberg","year":"2019","unstructured":"Strasberg SM (2019) A three-step conceptual roadmap for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review. J. Hepato-Biliary-Pancreatic Sci. 26:123\u2013127","journal-title":"J. Hepato-Biliary-Pancreatic Sci."},{"key":"7759_CR2","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1007\/s00268-015-3365-1","volume":"40","author":"B Tornqvist","year":"2016","unstructured":"Tornqvist B, Waage A, Zheng Z, Ye W, Nilsson M (2016) Severity of acute cholecystitis and risk of iatrogenic bile duct injury during cholecystectomy, a population-based case\u2013control study. World J Surg 40:1060\u20131067","journal-title":"World J Surg"},{"key":"7759_CR3","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1007\/s00464-018-6281-2","volume":"33","author":"EA Griffiths","year":"2019","unstructured":"Griffiths EA, Hodson J, Vohra RS, Marriott P, Katbeh T, Zino S, Nassar AHM (2019) Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy. Surg Endosc 33:110\u2013121","journal-title":"Surg Endosc"},{"key":"7759_CR4","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jamcollsurg.2015.09.019","volume":"222","author":"SM Strasberg","year":"2016","unstructured":"Strasberg SM, Pucci MJ, Brunt LM, Deziel DJ (2016) Subtotal cholecystectomy-\"fenestrating\" vs \"reconstituting\" subtypes and the prevention of bile duct injury: definition of the optimal procedure in difficult operative conditions. J Am Coll Surg 222:89\u201396","journal-title":"J Am Coll Surg"},{"key":"7759_CR5","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1007\/s00464-002-8621-4","volume":"17","author":"RS Chung","year":"2003","unstructured":"Chung RS, Wojtasik L, Pham Q, Chari V, Chen P (2003) The decline of training in open biliary surgery: effect on the residents' attitude toward bile duct surgery. Surg Endosc 17:338\u2013340","journal-title":"Surg Endosc"},{"key":"7759_CR6","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/SLA.0b013e3181c1b18e","volume":"251","author":"RS Chung","year":"2010","unstructured":"Chung RS, Ahmed N (2010) The impact of minimally invasive surgery on residents' open operative experience: analysis of two decades of national data. Ann Surg 251:205\u2013212","journal-title":"Ann Surg"},{"key":"7759_CR7","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1002\/jhbp.493","volume":"25","author":"RZ Panni","year":"2018","unstructured":"Panni RZ, Strasberg SM (2018) Preoperative predictors of conversion as indicators of local inflammation in acute cholecystitis: strategies for future studies to develop quantitative predictors. J Hepato-Biliary-Pancreat Sci 25:101\u2013108","journal-title":"J Hepato-Biliary-Pancreat Sci"},{"key":"7759_CR8","unstructured":"Kehr H (2018) Introduction to the differential diagnosis of the separate forms of gallstone disease: based upon his own experience gained in 433 laparotomies for gallstones, creative media partners, LLC"},{"key":"7759_CR9","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.hpb.2017.02.441","volume":"19","author":"ME Lidsky","year":"2017","unstructured":"Lidsky ME, Speicher PJ, Ezekian B, Holt EW, Nussbaum DP, Castleberry AW, Perez A, Pappas TN (2017) Subtotal cholecystectomy for the hostile gallbladder: failure to control the cystic duct results in significant morbidity. HPB 19:547\u2013556","journal-title":"HPB"},{"key":"7759_CR10","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1001\/archsurg.1938.01190230128009","volume":"36","author":"WL Eestes Jr","year":"1938","unstructured":"Eestes WL Jr (1938) Partial cholecystectomy. Arch Surg 36:849\u2013857","journal-title":"Arch Surg"},{"key":"7759_CR11","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1016\/S0140-6736(54)92210-2","volume":"266","author":"WE McElmoyle","year":"1954","unstructured":"McElmoyle WE et al (1954) Cholecystectomy: a method for the difficult gall-bladder. Lancet (London, England) 266:1320\u20131323","journal-title":"Lancet (London, England)"},{"key":"7759_CR12","first-page":"54","volume":"63","author":"AI Lerner","year":"1950","unstructured":"Lerner AI (1950) Partial cholecystectomy. Can Med Assoc J 63:54\u201356","journal-title":"Can Med Assoc J"},{"key":"7759_CR13","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.jamcollsurg.2009.12.004","volume":"210","author":"MR Porembka","year":"2010","unstructured":"Porembka MR, Hall BL, Hirbe M, Strasberg SM (2010) Quantitative weighting of postoperative complications based on the accordion severity grading system: demonstration of potential impact using the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 210:286\u2013298","journal-title":"J Am Coll Surg"},{"key":"7759_CR14","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/j.hpb.2018.10.015","volume":"21","author":"DW da Costa","year":"2019","unstructured":"da Costa DW, Schepers NJ, Bouwense SA, Hollemans RA, van Santvoort HC, Bollen TL, Consten EC, van Goor H, Hofker S, Gooszen HG, Boerma D, Besselink MG (2019) Predicting a 'difficult cholecystectomy' after mild gallstone pancreatitis. HPB 21:827\u2013833","journal-title":"HPB"},{"key":"7759_CR15","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12893-017-0319-6","volume":"17","author":"K Inoue","year":"2017","unstructured":"Inoue K, Ueno T, Douchi D, Shima K, Goto S, Takahashi M, Morikawa T, Naitoh T, Shibata C, Naito H (2017) Risk factors for difficulty of laparoscopic cholecystectomy in grade II acute cholecystitis according to the Tokyo guidelines 2013. BMC Surg 17:114","journal-title":"BMC Surg"},{"key":"7759_CR16","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1002\/jhbp.375","volume":"23","author":"Y Iwashita","year":"2016","unstructured":"Iwashita Y, Ohyama T, Honda G, Hibi T, Yoshida M, Miura F, Takada T, Han HS, Hwang TL, Shinya S, Suzuki K, Umezawa A, Yoon YS, Choi IS, Huang WS, Chen KH, Watanabe M, Abe Y, Misawa T, Nagakawa Y, Yoon DS, Jang JY, Yu HC, Ahn KS, Kim SC, Song IS, Kim JH, Yun SS, Choi SH, Jan YY, Sheen-Chen SM, Shan YS, Ker CG, Chan DC, Lee KT, Toyota N, Higuchi R, Nakamura Y, Mizuguchi Y, Takeda Y, Ito M, Norimizu S, Yamada S, Matsumura N, Shindoh J, Sunagawa H, Hasegawa H, Rikiyama T, Sata N, Kano N, Kitano S, Tokumura H, Yamashita Y, Watanabe G, Nakagawa K, Kimura T, Yamakawa T, Wakabayashi G, Endo I, Miyazaki M, Yamamoto M (2016) What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey. J Hepato-Biliary-Pancreat Sci 23:533\u2013547","journal-title":"J Hepato-Biliary-Pancreat Sci"},{"key":"7759_CR17","doi-asserted-by":"publisher","first-page":"2561","DOI":"10.1007\/s00464-013-2787-9","volume":"27","author":"G Cwik","year":"2013","unstructured":"Cwik G, Skoczylas T, Wyro\u015blak-Najs J, Wallner G (2013) The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis. Surg Endosc 27:2561\u20132568","journal-title":"Surg Endosc"},{"key":"7759_CR18","doi-asserted-by":"publisher","first-page":"3174","DOI":"10.1007\/s00464-012-2310-8","volume":"26","author":"SR Raman","year":"2012","unstructured":"Raman SR, Moradi D, Samaan BM, Chaudhry US, Nagpal K, Cosgrove JM, Farkas DT (2012) The degree of gallbladder wall thickness and its impact on outcomes after laparoscopic cholecystectomy. Surg Endosc 26:3174\u20133179","journal-title":"Surg Endosc"},{"key":"7759_CR19","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1002\/jhbp.515","volume":"25","author":"M Yokoe","year":"2018","unstructured":"Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, Kozaka K, Endo I, Deziel DJ, Miura F, Okamoto K, Hwang T-L, Huang WS-W, Ker C-G, Chen M-F, Han H-S, Yoon Y-S, Choi I-S, Yoon D-S, Noguchi Y, Shikata S, Ukai T, Higuchi R, Gabata T, Mori Y, Iwashita Y, Hibi T, Jagannath P, Jonas E, Liau K-H, Dervenis C, Gouma DJ, Cherqui D, Belli G, Garden OJ, Gim\u00e9nez ME, de Santiba\u00f1es E, Suzuki K, Umezawa A, Supe AN, Pitt HA, Singh H, Chan ACW, Lau WY, Teoh AYB, Honda G, Sugioka A, Asai K, Gomi H, Itoi T, Kiriyama S, Yoshida M, Mayumi T, Matsumura N, Tokumura H, Kitano S, Hirata K, Inui K, Sumiyama Y, Yamamoto M (2018) Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepato-Biliary-Pancreat Sci 25:41\u201354","journal-title":"J Hepato-Biliary-Pancreat Sci"},{"key":"7759_CR20","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1089\/lap.2006.0194","volume":"18","author":"M Tuveri","year":"2008","unstructured":"Tuveri M, Calo PG, Medas F, Tuveri A, Nicolosi A (2008) Limits and advantages of fundus-first laparoscopic cholecystectomy: lessons learned. J Laparoendosc Adv Surg Tech Part A 18:69\u201375","journal-title":"J Laparoendosc Adv Surg Tech Part A"},{"key":"7759_CR21","doi-asserted-by":"publisher","first-page":"2626","DOI":"10.1007\/s00464-010-0966-5","volume":"24","author":"C Hubert","year":"2010","unstructured":"Hubert C, Annet L, van Beers BE, Gigot JF (2010) The \"inside approach of the gallbladder\" is an alternative to the classic Calot's triangle dissection for a safe operation in severe cholecystitis. Surg Endosc 24:2626\u20132632","journal-title":"Surg Endosc"},{"key":"7759_CR22","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.jamcollsurg.2016.02.019","volume":"223","author":"KR Sirinek","year":"2016","unstructured":"Sirinek KR, Willis R, Schwesinger WH (2016) Who will be able to perform open biliary surgery in 2025? J Am Coll Surg 223:110\u2013115","journal-title":"J Am Coll Surg"},{"key":"7759_CR23","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1016\/j.jss.2007.03.073","volume":"142","author":"CI Schulman","year":"2007","unstructured":"Schulman CI, Levi J, Sleeman D, Dunkin B, Irvin G, Levi D, Spector S, Franceschi D, Livingstone A (2007) Are we training our residents to perform open gall bladder and common bile duct operations? J Surg Res 142:246\u2013249","journal-title":"J Surg Res"},{"key":"7759_CR24","first-page":"1","volume":"98","author":"PC Bornman","year":"1985","unstructured":"Bornman PC, Terblanche J (1985) Subtotal cholecystectomy: for the difficult gallbladder in portal hypertension and cholecystitis. Surgery 98:1\u20136","journal-title":"Surgery"},{"key":"7759_CR25","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1001\/jamasurg.2014.1219","volume":"150","author":"M Elshaer","year":"2015","unstructured":"Elshaer M, Gravante G, Thomas K, Sorge R, Al-Hamali S, Ebdewi H (2015) Subtotal cholecystectomy for \"difficult gallbladders\": systematic review and meta-analysis. JAMA Surg 150:159\u2013168","journal-title":"JAMA Surg"},{"key":"7759_CR26","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s00464-012-2458-2","volume":"27","author":"D Henneman","year":"2013","unstructured":"Henneman D, da Costa DW, Vrouenraets BC, van Wagensveld BA, Lagarde SM (2013) Laparoscopic partial cholecystectomy for the difficult gallbladder: a systematic review. Surg Endosc 27:351\u2013358","journal-title":"Surg Endosc"},{"key":"7759_CR27","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1016\/j.hpb.2018.05.005","volume":"20","author":"SJ Concors","year":"2018","unstructured":"Concors SJ, Kirkland ML, Schuricht AL, Dempsey DT, Morris JB, Vollmer CM, Drebin JA, Lee MK (2018) Resection of gallbladder remnants after subtotal cholecystectomy: presentation and management. HPB 20:1062\u20131066","journal-title":"HPB"},{"key":"7759_CR28","doi-asserted-by":"publisher","first-page":"e184","DOI":"10.1177\/000313481708300602","volume":"83","author":"L Tsamalaidze","year":"2017","unstructured":"Tsamalaidze L, Almerey T, Pereira L, Permenter S, Stauffer JA (2017) Laparoscopic excision of remnant gallbladder after subtotal cholecystectomy. Am Surg 83:e184\u2013185","journal-title":"Am Surg"},{"key":"7759_CR29","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.jamcollsurg.2017.05.016","volume":"225","author":"AH van Dijk","year":"2017","unstructured":"van Dijk AH, Donkervoort SC, Lameris W, de Vries E, Eijsbouts QAJ, Vrouenraets BC, Busch OR, Boermeester MA, de Reuver PR (2017) Short- and long-term outcomes after a reconstituting and fenestrating subtotal cholecystectomy. J Am Coll Surg 225:371\u2013379","journal-title":"J Am Coll Surg"},{"key":"7759_CR30","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3109\/13645709509152757","volume":"4","author":"AHM Nassar","year":"1995","unstructured":"Nassar AHM, Ashkar KA, Mohamed AY, Hafiz AA (1995) Is laparoscopic cholecystectomy possible without video technology? Minim Invasive Ther 4:63\u201365","journal-title":"Minim Invasive Ther"},{"key":"7759_CR31","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s13017-015-0005-x","volume":"10","author":"M Sugrue","year":"2015","unstructured":"Sugrue M, Sahebally SM, Ansaloni L, Zielinski MD (2015) Grading operative findings at laparoscopic cholecystectomy- a new scoring system. World J Emerg Surg 10:14\u201314","journal-title":"World J Emerg Surg"},{"key":"7759_CR32","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/S0140-6736(97)08005-7","volume":"351","author":"GB Hanna","year":"1998","unstructured":"Hanna GB, Shimi SM, Cuschieri A (1998) Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet (London, England) 351:248\u2013251","journal-title":"Lancet (London, England)"},{"key":"7759_CR33","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.1002\/bjs.10287","volume":"103","author":"CholeS Study Group WMRC","year":"2016","unstructured":"CholeS Study Group WMRC (2016) Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases. Br J Surg 103:1704\u20131715","journal-title":"Br J Surg"},{"key":"7759_CR34","doi-asserted-by":"publisher","first-page":"226","DOI":"10.4174\/astr.2016.91.5.226","volume":"91","author":"M Shin","year":"2016","unstructured":"Shin M, Choi N, Yoo Y, Kim Y, Kim S, Mun S (2016) Clinical outcomes of subtotal cholecystectomy performed for difficult cholecystectomy. Ann Surg Treat Res 91:226\u2013232","journal-title":"Ann Surg Treat Res"},{"key":"7759_CR35","doi-asserted-by":"publisher","first-page":"5258","DOI":"10.1007\/s00464-017-5599-5","volume":"31","author":"R Kirkwood","year":"2017","unstructured":"Kirkwood R, Damon L, Wang J, Hong E, Kirkwood K (2017) Gangrenous cholecystitis: innovative laparoscopic techniques to facilitate subtotal fenestrating cholecystectomy when a critical view of safety cannot be achieved. Surg Endosc 31:5258\u20135266","journal-title":"Surg Endosc"},{"key":"7759_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1477-2574.2011.00393.x","volume":"14","author":"SM Strasberg","year":"2012","unstructured":"Strasberg SM, Gouma DJ (2012) 'Extreme' vasculobiliary injuries: association with fundus-down cholecystectomy in severely inflamed gallbladders. HPB 14:1\u20138","journal-title":"HPB"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-020-07759-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-020-07759-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-020-07759-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:32:09Z","timestamp":1624926729000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-020-07759-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,29]]},"references-count":36,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["7759"],"URL":"https:\/\/doi.org\/10.1007\/s00464-020-07759-2","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,29]]},"assertion":[{"value":"30 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors for this manuscript have no relevant disclosures, funding sources or commercial interests related to the material presented in this study. Michael LeCompte, Keenan Robbins, Greg Williams, Dominic Sanford, Chet Hammill, Ryan Fields, William Hawkins have no relevant financial ties or conflicts of interest to disclose. Dr. Hawkins is on the board for Accuronix Therapeutics which has no relevance to the research or data presented in this study and does not receive any financial compensation from this association. Steven Strasberg has no relevant financial ties or conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}