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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
Sat Mar 10 2018
Journal Name
Opción
The Effect of Cognitive Modeling Strategy in chemistry achievement for students
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The aim of the current research is to verify the effect of the cognitive modeling strategy on the achievement of the chemistry course for the students of the first intermediate grade. To achieve the objective of the research, the null hypothesis was formulated via cognitive modeling strategy. The results showed that the experimental group's students performed better than the students in the control group. In the light of the results, the researchers concluded: The impact of the cognitive modeling strategy in the achievement of students of first intermediate grade in chemistry.

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Publication Date
Tue Apr 22 2025
Journal Name
Al–bahith Al–a'alami
SPECIALIZED JOURNALISM IN IRAQ : (After The Events of 09-04-2003)
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The specialized Journalism plays an important role in our daily lives using all of its different ways, including news, caricature, commentary and dialogue. The specialized Journalism deserves vigilance and interest for it is caring about having a new media system. It is meant by “specialization”, first: identifying the areas of work in which the person concerned possesses great knowledge in the specialty resulting from a long experience, it also means being able to continuously develop required skills in that specialty. The specialization is not only a feature of the press, but also a feature of human development; thousands of years ago, the primitive society consisted of people from different specializations: fishermen, farmers, her

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Publication Date
Sun Jan 01 2017
Journal Name
Lecture Notes In Computer Science
The Art of Using Cross-Layer Design in Cognitive Radio Networks
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Publication Date
Fri Jan 01 2021
Journal Name
Annals Of Parasitology
The role of intestinal protozoa in chronic obstructive pulmonary disease exacerbation
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chronic obstructive pulmonary disease (COPD) is a common respiratory disease with episodes of exacerbation. Variable factors including infectious pathogen can predispose for this exacerbation. The aim of this study is to evaluate the role of intestinal protozoa in COPD exacerbation. A total of 56 patients with COPD were included in this study. Patients were categorized into two groups based on the frequency of exacerbation during the last 6 months: those with ≤1 exacerbation (32 patients) and those with ≥2 exacerbations (24 patients). Stool specimens from each patient were collected two times (one week interval) examined for intestinal parasite. In univariate analysis, rural residence and parasitic infection were more common among patie

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Publication Date
Fri Sep 08 2006
Journal Name
Journal Of Engineering
INFLUENCE OF DEFECT IN THE CONCRETE PILES USING NON-DESTRUCTIVE TESTING
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This paper presents the results of experimental investigation carried out on concrete model piles to study the behaviour of defective piles. This was achieved by employing non-destructive tests using ultrasonic waves. It was found that the reduction in pile stiffness factor is found to be about (26%) when the defect ratio increased from (5%) to (15%). The modulus of elasticity reduction factor as well as the dynamic modulus of elasticity reduction factor increase with the defect ratio

Publication Date
Sun Apr 02 2023
Journal Name
Journal Of Survey In Fisheries Sciences
Evaluation of the Serum Asprosin Levels in Patients with Double Diabetes
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Background : Double diabetes (DD) is the term used to describe situations in which a patient exhibits characteristics that are a combination of type 1 diabetes mellitus(T1DM) and type 2 Diabetes Mellitus (T2DM) a large epidemiological study found that 25.5% of people with T1D also had the metabolic syndrome. A new protein hormone called asprosin is predominantly released by white adipose tissue. It was initially discovered in 2016 . Asprosin is important diagnoses marker for insulin resistant in diabetes patients ,additionally is very important denotation about early diagnoses of type 2 diabetes. Objectives: The current study aims to find predictive significance of diagnosis a double diabetes by evaluating the asprosin in the blood serum of

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Publication Date
Thu Apr 13 2023
Journal Name
Journal Of Survey In Fisheries Sciences
The Elevation of Serum Subfatin Levels in Patients with Double Diabetes
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Background: Hybrid diabetes (or double diabetes, DD) occur when the patient which exhibits characteristics that combine type 1 diabetes (T1DM) and type 2 diabetes (T2DM). Formerly epidemiological studies found that quarter of people with T1D also had the metabolic syndrome. Subfatin, Also called cometin, it is a small (~27kDa) cytokine secreted by protein encoded by a gene called METRNL (simeler of meteorin). is much expressed in skin in the mucosal tissues and activated macrophages. Subfatin has also been described as a hormone that effected in some diseases such as metabolic diseases (including dyslipidemia), type 2 diabetes and obesity. Objectives: The current study objective is evaluating the subfatin in the blood serum of double diabet

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Publication Date
Thu Jul 01 1999
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
Helminth parasites of the kestrel Falco tinnunculus L. 1758 in Iraq
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The kestrel Falco tinnunculus specimens coIldeted in Iraq are found infected with one or more species of the following helminthes; Physaloptera alata (Nematoda), Cladataenia globifera (Cestoda), Prosthogonimus cuneatus (Trernatoda), and Sphaeriorostris sp. (Acanthocephala) with a total infection rate of 30.56%. The results are compared and discussed with the pertinent literature.

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Publication Date
Thu Jul 04 2019
Journal Name
Journal Of Research In Medical And Dental Science
The Role of Epithelial Mesenchymal Transition Process in Inflammatory Gingival Hyperplasia
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The using effects of Nettle herb in elevating Hb&PCV levels
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A dose of ten grams of the roots and leaves of Nettle (Urtica dioica) dissolved in (200)ml of boiled water then covered for (10)min. was given to a sample of (15) patients attending to the herbal department of ministry of health complaining of malnutrition and low Hb(hemoglobin) concentration and PCV(packed cell volume) levels with absence of any other predisposing factors disease inorder to find the effects of these roots and leaves on Hb and PCV levels for different periods of time in relation to age and sex variations . The study have shown that this mixture has a high significant effect (p<0.001) in elevating (Hb) concentration and PCV levels on those patients according to the differences recorded from the start of the basic period unt

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