{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:54:14Z","timestamp":1781798054263,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"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":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Subtotal cholecystectomy is an important bailout procedure for difficult cholecystitis cases. Two novel closure techniques have been described: the fenestrating method (F-method) using Endoloop ligation and the reconstituting method (R-method) using barbed sutures. This study aimed to compare the short- and long-term outcomes of these two techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study included 52 patients who underwent laparoscopic subtotal cholecystectomy between January 2022 and December 2025, with 33 patients in the F-method group and 19 patients in the R-method group. The primary outcome was early postoperative complications. The secondary outcomes included late complications, operative time, and remnant gallbladder tissue on imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients in the R-method group were significantly older (median: 72 versus 62 years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .021) and had more severe cholecystitis (Tokyo Guidelines grade \u2265 II: 79.0% versus 45.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .023). Unclear anatomy was more common in the R-method group (84.2% versus 21.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Closure time was significantly shorter in the F-method group (4 versus 18 minutes,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). No bile duct injury, bile leakage, or mortality was observed in either group. Among patients who underwent postoperative imaging, remnant gallbladder tissue was identified in 35.7% of patients in the R-method group and 0% in those in the F-method group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .012). One patient in each group developed late complications that required readmission (F-method, common bile duct stone; R-method, remnant cholecystitis).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Both methods are safe and have distinct complication profiles. The F-method eliminates remnant gallbladder tissue, whereas the R-method is suitable when complete dissection poses a risk of injury. Technique selection should be based on intraoperative findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261462337","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:55:56Z","timestamp":1781661356000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoloop Fenestration Versus Barbed Suture Reconstitution in Laparoscopic Subtotal Cholecystectomy: A Comparative Analysis of Complications and Outcomes"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6602-0042","authenticated-orcid":false,"given":"Nao","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiyasu","family":"Okamura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Shindate","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Mitsuka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Aramaki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Narumiya","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, 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