{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:41:22Z","timestamp":1782301282229,"version":"3.54.5"},"reference-count":20,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An increasing body of literature supports subtotal cholecystectomy (STC) in the management of patients with difficult gallbladder anatomy; however, large-scale studies examining outcomes of total cholecystectomy and STC are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All adults undergoing total cholecystectomy or STC were tabulated from the 2016-2019 Nationwide Readmissions Database. Entropy balancing was performed to adjust for patient differences based on extent of resection. Subsequent multivariable regression models were used to assess the association of STC with major adverse events, postoperative length of stay (pLOS), hospitalization costs, and 30-day non-elective readmission rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of an estimated 854\u00a0357 patients, 7089 (.8%) underwent STC. Compared to total, STC patients were significantly older, less commonly female, and had a higher Elixhauser Index (all P &lt; .001). Both cohorts had similar rates of postoperative ERCP (1.7% vs 1.5%, P = .33); however, the STC cohort had significantly higher utilization of subsequent drainage procedures (1.8% vs .5%, P &lt; .001). After entropy balancing and multivariable risk-adjustment, STC was not associated with greater odds of MAE (AOR 1.11, 95% CI .99-1.23, P = .06). Notably, relative to total, STC was associated with longer pLOS ( \u03b2 .14, 95% CI .11-.17, P &lt; .001) and greater hospitalization costs (\u03b2 + $1,900, 95% CI 1300-2,500, P &lt; .001). However, the extent of resection was not associated with the likelihood of 30-day non-elective readmission (AOR 1.01, 95% CI .91-1.13, P = .86).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings suggest that STC is a viable, yet resource intensive, option in the management of complex cholecystitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231175145","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T11:00:49Z","timestamp":1683716449000},"page":"4013-4017","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of Postoperative Outcomes, Costs, and Readmission Between Total and Subtotal Cholecystectomy"],"prefix":"10.1177","volume":"89","author":[{"given":"Nikhil L.","family":"Chervu","sequence":"first","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"},{"name":"Depatment of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amulya","family":"Vadlakonda","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"},{"name":"Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nameer","family":"Ascandar","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"},{"name":"Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Kronen","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Shahyan","family":"Bakhtiyar","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"},{"name":"Department of Surgery, University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam Yong","family":"Cho","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"},{"name":"Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyman","family":"Benharash","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, CA, USA"},{"name":"Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, 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