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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
Wed May 01 2024
Journal Name
научный форум
jargon and slang: similarities and differences and their role in the Russian language
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Publication Date
Tue Sep 05 2023
Journal Name
Pakistan Heart Journal
The Effect of Dynamic Lactic Training According to the Target Time to Develop the Achievement of 800m Runners Under 20 Years Old
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MA Mahde, HAA Kadhim, HN Tarish…, Pakistan Heart Journal, 2023 - Cited by 4

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Publication Date
Thu Dec 31 2020
Journal Name
College Of Islamic Sciences
The Epistemological The Epistemological Foundations for Comparison of Religions by al-Amiri: The Epistemological Foundations for Comparison of Religions by al-Amiri
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 Research topic: (The Epistemological Foundations for Comparison of Religions by al-Amiri)

The research sought to study the topic with: a descriptive methodology by investigating the components of al-Amiri's approach to the interfaith comparison. And analytical, by showing the applied perception of an objective model in the comparison of religions to answer two questions: What are the cognitive foundations of al-Amiri? And what is his approach to establishing an objective comparison between religions?

The research started by introducing Abu al-Hassan al-Amiri, and then presented four topics: An introduction to al-Amiri's efforts in the interfaith comparison, his knowledge foundations, an applied model

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Publication Date
Thu Jun 27 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
RECORD OF THE BARNACLE OCTOLASMIS ANGULATA (AURIVILLIUS, 1894) FROM THE GILLS OF THE CRAB PORTUNUS SEGNIS (FORSKÅL, 1775) OFF IRAQI MARINE WATERS
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    Ten blue swimming crabs Portunus segnis (Forskål, 1775) were collected from the north west of the Arabian Gulf off the Iraqi marine waters from October to November 2017 at 29ᵒ 37′ N to 48ᵒ 47′ E.

     The barnacle Octolasmis angulata (Aurivillius, 1894) was found on the gills of the present species of crab, the mean incidence of infestation was 30%, while the mean Intensity of infestation was 12.3. The barnacle have a long and slim shaped calcareous plate with the presence of carina and the absence of tergum, in addition to the elongated shape of carina and scutum. The current study represents the first record of the barnacle O. angulata in the Ar

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
Experimental and Modeling Study of Abrasive Wear of Tungsten Carbide Drilling Bit in Wet and Dry Conditions
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The results of theoretical and experimental investigations carried out to study the effect of load and relative sliding speed on the abrasive wear behavior in drilling bit teeth surfaces of an insert tungsten carbide bit have been presented. Experimentally, an apparatus for abrasive wear tests conducted on the modified ASTM-G65 was modified and fabricated to facilitate loading and measurement of wear rate for the sand/ steel wheel abrasion test, which involves two cases of contact; first is at dry sand and second is under wet condition. These tests have been carried under varied operating parameters of normal load and sliding speed. A theoretical model based upon the Archard equation has been developed for predicting wear simulation by u

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Publication Date
Tue Dec 26 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Analytical Study of Bending Stresses and Deflections in Curved Beam Made of Laminated Composite Material
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Abstract

 

Theoretical and experimental methodologies were assessed to test curved beam made of layered   composite material. The maximum stress and maximum deflection were computed for each layer and the effect of radius of curvature and curve shape on them. Because of the increase of the use of composite materials in aircraft structures and the renewed interest in these types of problems, the presented theoretical assessment was made using three different approaches: curved beam theory and an approximate 2D strength of material equations and finite element method (FEM) analysis by ANSYS 14.5 program for twelve cases of multi-layered cylindrical shell panel differs in fibe

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives J.
Evaluation of the performance of introduced varieties of maize under different planting dates and environments
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Scopus
Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Ovonic Research
Effect of dopant of aluminum on the structural and optical properties of NiTsPc thin films
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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Awareness of the problem technological poisoning Media of parents of kindergarten children and their teachers
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The childhood stage is considered the most important stage of all the stages through
the human being’s life. In this stage the human being will be more affected by the various
factors that surround him/her. The first five years of his/her life leave a great impact not only
on the human being personality, but also on his/her whole life. Therefore, it is worthwhile tobe concerned with and focus at the raising up and the teaching of the child during the
childhood stage.
The mission of raising up children in this era - the era of globalization and information
bursting or news flooding – has become a very difficult or even an impossible mission.
Furthermore, not only in the Arabic world, but also all over the world, t

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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Engineering And Applied Sciences
Investigation of the Optical and Electrical Properties of Composites of PVA-PVP-PEG/ZnO Nanoparticles
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