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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Thu Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
The literature of the teacher and learner is a study in the light of “Holly Quran
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Praise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is  a slave to Allah  and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.

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Publication Date
Thu Dec 30 2021
Journal Name
College Of Islamic Sciences
Heralds of victory and empowerment of Islam From the texts and reality that the Noble Prophet (s) prophesied about
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Idea of ​​research

The global vision for the future of mankind and societies to achieve supremacy, empowerment and victory is limited to the sincerity of the sincere Islamic vision and its evidence, and this true vision is presented through the texts of the Noble Qur’an, the Sunnah of the Prophet and the concrete reality to achieve victory and empowerment of Islam, and does not respond by tracking the movement of history and its interventions.

The Islamic nation is a nation of survival and continuity with God’s promise and it needs to wake up and alert, and leadership that takes its hand into the path of victory and empowerment, and that this promise fulfills conditions of the most important of these is a promis

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of International Dental And Medical Research
The effects of progesterone administration in mice during pregnancy on ovarian development and anogenital distance of the offspring
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Progesterone is highly used in pregnant women as therapeutic agent to maintain and support pregnancy. To explore the effects of progesterone usage allover gestation till 7days postnatally on mice offspring ovaries development and anogenital distance. Ten pregnant mice were equally divide into control group that was injected with sesame oil which is used as a solvent for progesterone and treated group that is daily intraperitoneally injected with progesterone (dissolved in sesame oil 1: 10) at dose 10.2 mg/kg (the equivalent human dose) all through gestation till7day postnatal then sacrificed and measuring the anogenital distance (the distance between anus and genital papilla). Histological slides were prepared, and Diameters of the ovary, p

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Scopus
Publication Date
Wed Oct 05 2016
Journal Name
Al-academy
Dialectical relationship between digital Technique and aesthetic Picture TV
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The technical development has significant effects on the mediator Alcinmatugrave, and TV originated mainly based on technical, with the development and the continuation of these technologies and the enormous impact on the level of the television picture, initially dramas in recent times approaching in the aesthetic composition of the film thanks to the employment of modern digital technologies, Montag was not only one of the cinematic elements that went into television thanks to technical developments analogue and digital, and which added the possibility of large processors in the picture, high-definition digital cameras that have led to dispense often for artificial lighting intensive imaging light available, as these cameras have helpe

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Possible Options in Managing the Exchange Rate of the Iraqi Currency in light of Current Economic Conditions
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The management of the exchange rate of the most important tools of economic policy because of its wide area in achieving stability and economic growth through the provision of stability in the exchange rate of the currency of the country concerned , as well as the impact and influence of money supply and then treat the economic crisis monetary and reduce the risk of currency exchange rate .For the management of the exchange rate in Iraq has passed through several stages , from installation to link to a basket of currencies to float freely , and we are dealing with in this research regard to the achievements of monetary policy , especially after the enjoyment of independence on according to the Iraqi Central Bank Law No. 56 of 2004 and Ma

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Publication Date
Wed Dec 01 2021
Journal Name
Iraqi Journal Of Physics
Effect of Zinc (Zn) -Doped on the Structural, Optical and Electrical Properties of (Cdo)1-Xznx Films Prepared by Pulsed Laser Deposition Technique
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Pure cadmium oxide films (CdO) and doped with zinc were prepared at different atomic ratios using a pulsed laser deposition technique using an ND-YAG laser from the targets of the pressed powder capsules. X-ray diffraction measurements showed a cubic-shaped of CdO structure. Another phase appeared, especially in high percentages of zinc, corresponding to the hexagonal structure of zinc. The degree of crystallinity, as well as the crystal size, increased with the increase of the zinc ratio for the used targets. The atomic force microscopy measurements showed that increasing the dopant percentage leads to an increase in the size of the nanoparticles, the particle size distribution was irregular and wide, in addition, to increase the surfac

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Publication Date
Thu Aug 31 2017
Journal Name
Available At Ssrn 3030385
Synthesis, Spectral Studies And Antimicrobial Activity Of Mixed Ligand Complexes Of Cephalexin And Dimethylglyoxime With Some First Row Transition Metal Ions
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In this paper ,six new mixed metal ligand complexes are reported with Cephalexin (Ceph.H)as a primary ligand and Dimethylglyoxime (DMG) as secondary ligand with metal Chloride [MCl2 .nH2O. M=Mn(II),Co(II),Cu(II),Ni(II) and Zn(II),n=0-6] ,CrCl3.6H2O.The complexes are of (1:1:1)(Metal:Ligand: Ligand) Stoichiometry.The structures of these complexes are confirmed by using FT-IR and UV- electronic spectroscopies, magnetic moments, melting points, molar conductivity measurements and the metal % analysis revealed that the complexes analyze indicates a four coordinated as (A)=[M(HDMG) (Ceph)] .M=[Ni(II)and Zn(II).Six coordinated as (B) = K2[M(DMG)(CePh)(H2O)]. M= Mn (II),Co(II) and Cu(II) and (C)=[Cr(DMG)(Ceph)]Cl2. Interestingly, the in-vitro anti

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
REVIEW THE ASSESSMENT OF EFFECTS OF LOST TIME INJURIES IN AN INDUSTRIAL SYSTEM BY USING AN EXPLANATORY PROGRAM
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Health and safety problem can be described by statistics it can only be understood by knowing and feeling the pain, suffering, and depression. Health and safety has a legal responsibility to protect it for everyone who can affect in the workplace. This includes manufacturers, suppliers, designers and controllers of work places and employees. Work injury is one of the major problems in manufacturing and production systems industries; it is reduced production efficiency and affects the cost. To gain flexibility from a traditional manufacturing system and production efficiency, this paper is about the application of estimating technology to preview and synthesis of Lost Time of Work Injuries in industry systems aims to provide a safe workin

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Publication Date
Sat Apr 01 2017
Journal Name
Iosr Journal Of Computer Engineering (iosr-jce)
A New Approach to DNA, RNA, and Protein Motifs Templates Visualization and Analysis via Compilation Technique
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Motifs template is the input for many bioinformatics systems such codons finding, transcription, transaction, sequential pattern miner, and bioinformatics databases analysis. The size of motifs arranged from one base up to several Mega bases, therefore, the typing errors increase according to the size of motifs. In addition, when the structures motifs are submitted to bioinformatics systems, the specifications of motifs components are required, i.e. the simple motifs, gaps, and the lower bound and upper bound of each gap. The motifs can be of DNA, RNA, or Protein. In this research, a motif parser and visualization module is designed depending on a proposed a context free grammar, CFG, and colors human recognition system. GFC describes the m

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Publication Date
Tue Jun 09 2026
Journal Name
Magazine Of College Administration&amp;economics For Economic &amp; Administration &amp; Financial Studies
The Design of Optimal Layout Using Computerized Relative Allocation of Facilities Technique (CRAFT) - Applied Research in Al-M&#39;ammon Factory / The General Company for Vegetable Oils Industry
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