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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
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 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
Tue Jan 01 2019
Journal Name
Plant Archives
The role of some cytokines in diabetic patients infected with toxoplasmosis
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Toxoplasmosis is the term for infection and disease in man and animal caused by a parasite called Toxoplasma gondii. The more susceptible to infect with toxoplasmosis is the Diabetic patients, due to low level of immunity response. The aim of current study is to investigate the immune status of diabetes mellitus type 2. One hundred and seventy five samples of both diabetes mellitus type 2patients and controls which had been tested by ELISA technique to detect anti-Toxoplasma Abs (IgG and IgM). The positive toxoplasmosis samples were tested to detect the level of TNF alpha and MIG. Results for all samples clarified that seronegative for IgM antibodies while 53 (53%) diabetic patients were seropositive for IgG antibodies and for toxoplasmosis

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Publication Date
Mon Jan 01 2024
Journal Name
Current Research In Pharmacology And Drug Discovery
Papaverine attenuates the progression of alpha naphthylisothiocyanate induce cholestasis in rats
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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Body Language in the Poetry of Ibn Al-Jayab Al-Farnati
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Language is a means of communication among the human beings. Every language that distinguish them from others. However, there is language common that is common of all human beings without discrimination and expression of ideas. Perhaps it is more honest that the usual language.

            The research is divided into a preface which speaks about the meaning of body language. Then we speak about body gestures like the eyes, hand, the tongue the heart reaching up the conclusion in which we found that the body language is one of the terms included in the Holy Quran, which has original roots. But this term is recently common and spread in the present time. Most of those who tack

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Effect Of Time Driven Activity Based Costing in Pricing Decisions
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The research aims to demonstrate the impact of TDABC as a strategic technology compatible with the rapid developments and changes in the contemporary business environment) on pricing decisions. As TDABC provides a new philosophy in the process of allocating indirect costs through time directives of resources and activities to the goal of cost, identifying unused energy and associated costs, which provides the management of economic units with financial and non-financial information that helps them in the complex and dangerous decision-making process. Of pricing decisions. To achieve better pricing decisions in light of the endeavor to maintain customers in a highly competitive environment and a variety of alternatives, the resear

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Publication Date
Sat Dec 01 2012
Journal Name
Iraqi Journal Of Science
Applications of Camera Total Station System (CTSS) in the Construction Surveying
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AZ Khalaf, M kassim Haidir, LK Jasim, Iraqi Journal of Science, 2012

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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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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of transcendental leadership in enhancing university performance (Field research)
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Current research aims to analyze the relationship and impact of the explanatory variable transcendental leadership, which includes dimensions (values ​​and attitudes, behavior, spirituality, vision and hope/faith) in the responsive variable university performance dimensions (relationships and resources available, human capital development, scientific research, community service). Field research for the leaders of a number of colleges of the University of Baghdad of the deans of the colleges of research and assistants of deans and heads of departments, the main research problem was the important question (what is the role of transcendent leadership in promotin

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
The Use of Bracing Dampers in Steel Buildings under Seismic Loading
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This study focuses on the modeling of manufactured damper when used in steel buildings. The main aim of the manufactured dampers is to protect the steel buildings from the damaging effects that may result due to earthquakes by introducing an extra damping in addition to the traditional damping.
Only Pure Manufactured Dampers, has been considered in this study. Viscous modeling of damping is generally preferred in structural engineering as it leads to a linear model then it has been used during this study to simulate the behavior of the Pure Manufactured Damper.
After definition of structural parameters of a manufactured damper (its stiffness and its damping) it can be used as a structural element that can be added to a mathematica

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