{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:41:20Z","timestamp":1782301280011,"version":"3.54.5"},"reference-count":17,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/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":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A difficult laparoscopic cholecystectomy (LC) confers an increased risk of bile duct injury. Traditionally, surgeons convert to open cholecystectomy (OC) as a bailout procedure for safer dissection. Laparoscopic subtotal cholecystectomy (LSC) has recently gained favor with comparable short-term complication rates, but differences in long-term outcomes remain unknown. We sought to compare long-term biliary outcomes between OC and LSC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We performed a single-center retrospective cohort study of adults who underwent non-elective LC converted to OC or LSC due to difficult dissection from 1\/1\/2015 to 12\/31\/2019. The primary outcome was a composite measure of postoperative biliary events, and we used time-to-event analysis to compare the 2 groups. We evaluated secondary outcomes using Chi-squared or independent t-tests as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1089 patients who underwent non-elective LC, 68 (6%) underwent a bailout procedure (30 OC vs 38 LSC). There were no differences in demographics or comorbidities between the groups. Most patients (84%) had acute cholecystitis. Average follow-up times were 40 \u2213 29 months in OC and 54 \u2213 21 months in LSC. Biliary events occurred in 13 total patients (19%) with OC most commonly suffering bile leak (17%) and LSC most commonly having choledocholithiasis (11%). Kaplan-Meier analysis demonstrated no significant difference in biliary events between the groups (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.71). Secondary outcomes were all similar between groups, except LSC had a shorter length of stay (2.9 \u2213 2.3 vs 5.1 \u2213 3.6 days,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OC and LSC demonstrated comparable long-term biliary outcomes. In a difficult LC, surgeons may perform either bailout procedure to safely manage the gallbladder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251318380","type":"journal-article","created":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T22:06:37Z","timestamp":1738533997000},"page":"819-825","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of Long-Term Outcomes Between Conversion to Open and Laparoscopic Subtotal Cholecystectomy in the Difficult Gallbladder: A Single-Center Retrospective Study"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0590-7682","authenticated-orcid":false,"given":"Shivani B.","family":"Badve","sequence":"first","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Turcotte","sequence":"additional","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane C.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Klune","sequence":"additional","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina B.","family":"Feather","sequence":"additional","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Rehrig","sequence":"additional","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyus S.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Surgery, Luminis Health, Annapolis, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00336-x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00392-x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6333-7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-07242-7"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.06.047"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2016.09.024"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.11.004"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.09.019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1219"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.05.016"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2021.09.018"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2023.09.005"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-10-101"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004649901135"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2020.04.003"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.04.083"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004337"}],"container-title":["The 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