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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
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Situation of Refugees and Displaced Women in Arab Countries during Conflicts According to the Perspective of the Arab Women's Organization
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Abstract

The scope of the humanitarian tragedies in the Arab region has widened after the conflicts that erupted over the past years, exacerbation to include educational, cultural, and social dimensions, economic and moral aspects of the displaced families, especially after the emergence of terrorist organizations and sectarian conflicts which overthrew human and led to various political and demographic changes, forcing citizens to leave their homes, fleeing with their families from the danger of murder, terrorism, and violation to other safer areas inside or outside their countries. Women and children were the vast majority of the displaced who were subjected to great pressures, The host communities bore the pro

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Publication Date
Wed Aug 01 2018
Journal Name
European Journal Of Pharmaceutical Sciences
The effect of size and polymer architecture of doxorubicin–poly(ethylene) glycol conjugate nanocarriers on breast duct retention, potency and toxicity
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Publication Date
Tue Jun 20 2023
Journal Name
Bulletin Of The Iraq Natural History Museum
SURVEY WITH REVISED CHECKLIST OF COMPOSITAE IN THE HERBARIUM OF IRAQ NATURAL HISTORY RESEARCH CENTER AND MUSEUM
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A survey and revised checklist of the species belonging to the family of Compositae for the specimens which are collected and deposited previously at the herbarium of the Iraq Natural History Research Center and Museum, in addition to the current specimens collected for the period 2016-2021. A total of 85 species belonging to 49 genera and 16 tribes are revised with their synonyms, locality, and distributions, flowering and fruiting period.

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Publication Date
Fri Jul 30 2021
Journal Name
Coatings
A Past, Present, and Prospective Review on Microwave Nondestructive Evaluation of Composite Coatings
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Recent years have witnessed an increase in the use of composite coatings for numerous applications, including aerospace, aircraft, and maritime vessels. These materials owe this popularity surge to the superior strength, weight, stiffness, and electrical insulation they exhibit over conventional substances, such as metals. The growing demand for such materials is accompanied by the inevitable need for fast, accurate, and affordable nondestructive testing techniques to reveal any possible defects within the coatings or any defects under coating. However, typical nondestructive testing (NDT) techniques such as ultrasonic testing (UT), infrared thermography (IRT), eddy current testing (ECT), and laser shearography (LS) have failed to p

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Publication Date
Thu Jun 01 2017
Journal Name
كلية التربية للبنات
The rights of orphans in the Old Testament and Islam, a Comparative Study
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Allah Almighty has aggrandized the position of orphans and elevated their status in the society and has given the graces for those who sponsor the orphan and care for and protecting them, even those who rub their heads. The divine care is manifested in the verses of the Holy Bible and the Holy Quran. Therefore, the whole world cared for the orphan, and called for the rights of the orphans in the conferences and the channels. But all that was little effort that does not meet what the orphan need and some were only ink on paper that were not applied. All that mentioned above is necessary in dealing with the study (the rights of orphans in the Old Testament and Islam, a Comparative Study). The study was divided into a Preface and four inquirie

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Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
GEOMETRY OPTIMIZATION OF COUPLING ALLIN -METFORMIN USING DFT/B3LYP MOLECULAR MODELLING TECHNIQUE: GEOMETRY OPTIMIZATION OF COUPLING ALLIN -METFORMIN USING DFT/B3LYP MOLECULAR MODELLING TECHNIQUE
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This researchpaper includes the incorporation of Alliin at various energy levels and angles 

With Metformin using Gaussian 09 and Gaussian view 06. Two computers were used in this work. Samples were generated to draw, integrate, simulate and measure the value of the potential energy surface by means of which the lowest energy value was (-1227.408au). The best correlation compound was achieved between Alliin and Metformin through the low energy values where the best place for metformin to b

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Publication Date
Wed Jan 01 2020
Journal Name
Says Rev Pharm
Healing of apical periodontitis after minimally invasive endodontics therapy using Er,Cr:YSGG laser: A prospective clinical study
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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE FALCONS (FALCONIFORMES, FALCONIDAE) VOUCHER COLLECTION IN THE IRAQ NATURAL HISTORY RESEARCH CENTER AND MUSEUM (INHM)
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A total of 45 voucher specimens of falcons which are deposited in the bird's collection of the Iraq Natural History Research Center and Museum (INHM) were reviewed. Mummified falcons were preserved as voucher study specimens and tagged with museum collection labels. In the current study, morphometrics of six species of the genus Falco Linnaeus, 1758: Lanner falcon F. biarmicus Temminck, 1825; Sacker Falcon F. cherrug Gray, 1834; Lesser Kestrel F. naumanni Fleischer, 1818; Peregrine Falcon F. peregrines Tunstall, 1771; Eurasian Hobby F. subbuteo Linnaeus, 1758 and Common Kestrel F. tinnunculus Linnaeus, 1758 were documented.
These species were recorded previously in the ornithological literatures by several authors and deposited in the

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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum
THE FALCONS (FALCONIFORMES, FALCONIDAE) VOUCHER COLLECTION IN THE IRAQ NATURAL HISTORY RESEARCH CENTER AND MUSEUM (INHM)
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A total of 45 voucher specimens of falcons which are deposited in the bird's collection of the Iraq Natural History Research Center and Museum (INHM) were reviewed. Mummified falcons were preserved as voucher study specimens and tagged with museum collection labels. In the current study, morphometrics of six species of the genus Falco Linnaeus, 1758: Lanner falcon F. biarmicus Temminck, 1825; Sacker Falcon F. cherrug Gray, 1834; Lesser Kestrel F. naumanni Fleischer, 1818; Peregrine Falcon F. peregrines Tunstall, 1771; Eurasian Hobby F. subbuteo Linnaeus, 1758 and Common Kestrel F. tinnunculus Linnaeus, 1758 were documented. These species were recorded previously in the ornithological literatures by several authors and deposited in t

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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum
THE FALCONS (FALCONIFORMES, FALCONIDAE) VOUCHER COLLECTION IN THE IRAQ NATURAL HISTORY RESEARCH CENTER AND MUSEUM (INHM)
...Show More Authors

A total of 45 voucher specimens of falcons which are deposited in the bird's collection of the Iraq Natural History Research Center and Museum (INHM) were reviewed. Mummified falcons were preserved as voucher study specimens and tagged with museum collection labels. In the current study, morphometrics of six species of the genus Falco Linnaeus, 1758: Lanner falcon F. biarmicus Temminck, 1825; Sacker Falcon F. cherrug Gray, 1834; Lesser Kestrel F. naumanni Fleischer, 1818; Peregrine Falcon F. peregrines Tunstall, 1771; Eurasian Hobby F. subbuteo Linnaeus, 1758 and Common Kestrel F. tinnunculus Linnaeus, 1758 were documented. These species were recorded previously in the ornithological literatures by several authors and deposited in t

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