{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:19:41Z","timestamp":1791371981131,"version":"4.3.1"},"reference-count":44,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: A difficult gallbladder anatomy augments the risk of bile duct injuries (BDIs) and other complications during a laparoscopic cholecystectomy. This study compares the outcomes of a laparoscopic subtotal cholecystectomy (LSTC) and open total cholecystectomy (OTC) for difficult cholecystectomies. Materials and Methods: This retrospective analysis of gallbladder procedures (LSTC or OTC) from 2016 to 2023 examined patient demographics, surgical details, and postoperative results. The primary outcome was the incidence of a BDI. Secondary outcomes included operative duration, blood loss, and postoperative complications. Results: Seventy-one patients were included in the study. Of them, 59.2% (n = 42) underwent an LSTC and 44.6% (n = 29) underwent an OTC. The LSTC cohort was more likely to have a day-surgery case with a same-day discharge (33.3% vs. 0%, p = 0.009), less blood loss (71.4 \u00b1 82.26 vs. 184.8 \u00b1 234.86, p = 0.009), and a shorter operative duration (187.86 \u00b1 68.74 vs. 258.62 \u00b1 134.52 min, p = 0.008). Furthermore, BDI was significantly lower in the LSTC group (2.4% vs. 17.2%, p = 0.045). However, there were no significant differences between the two groups concerning intraoperative drain placement, peri-cholecystic fluid collection, bile leak, and other complications (p &gt; 0.05). Conclusions: LSTC is a safe and effective alternative to OTC for challenging gallbladder cases. Further studies with larger sample sizes and longer follow-up periods as well as different study designs are warranted.<\/jats:p>","DOI":"10.3390\/medicina60101642","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:29:26Z","timestamp":1728361766000},"page":"1642","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Bailout for the Difficult Gallbladder: Subtotal vs. Open Cholecystectomy\u2014A Retrospective Tertiary Care Center Experience"],"prefix":"10.3390","volume":"60","author":[{"given":"Abdullah","family":"Aloraini","sequence":"first","affiliation":[{"name":"Division of General Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3313-6292","authenticated-orcid":false,"given":"Ahmed","family":"Alburakan","sequence":"additional","affiliation":[{"name":"Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah Saad","family":"Alhelal","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada","family":"Alabdi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hend","family":"Elmutawi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0714-8402","authenticated-orcid":false,"given":"Najd Saeed","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alkhalife","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6215-0042","authenticated-orcid":false,"given":"Tariq","family":"Alanezi","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"},{"name":"College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1007\/s00464-017-5974-2","article-title":"Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: A systematic review and pooled data analysis","volume":"32","author":"Pucher","year":"2018","journal-title":"Surg. 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