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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 Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Influence of Teacher and Students Errors Correction Techniques on Students’ Achievement in English at College of Physical Education for Women
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The research is an attempt to investigate experimentally the influence of teacher’s errors correction and students’ errors correction on teaching English at the College of Physical Education for Women. Errors are seen as a natural way for developing any language but teachers are puzzled the way they can correct these errors. So, this research gives some idea of using two types of errors correction. The sample of the research is female students of the first year stage at the College of Physical Education for Women of the academic year 2009-2010. The whole population of the research is (94) students while the sample is (64). Thus, the sample represents 68% from the population of the research. The sample represents It is hypothesized th

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Publication Date
Sat Aug 21 2021
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Immunohistochemical Expression of Retinoblastoma Gene Product and p53 Protein in Transitional Cell Carcinoma of the Urinary Bladder and its Relationship to Different Clinicopathological Parameters
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BACKGROUND: Carcinoma of urinary bladder is one of the most common malignancies worldwide and constitutes a major health problem. Multiple risk factors are associated with this tumor and its prognosis will depend on different clinicopathological parameters. Over expression of P53 protein and mutant Rb gene is associated with more aggressive clinical and histopathological features of the tumor such as advanced stage and higher grade. AIM: The immunohistochemical expression of Rb gene and P53 gene will be assessed through their protein products in transitional cell carcinoma (TCC) of the urinary bladder and then will be correlated with other well-known risk factors and prognostic parameters of bladder TCC, such as grading, tumor size, smoking

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Publication Date
Tue Mar 01 2011
Journal Name
Iraqi Journal Of Science
EVALUATION OF THE TOXICITY OF DIFFERENT NICOTINE SULFATE CONCENTRATIONS IN CONTROLLING NYMPHAL INSTARS AND ADULTS OF CABBAGE APHID BREVICORYNE BRASSICAE (L.)(HOMOPTERA: APHIDIDAE)
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Publication Date
Tue Jan 18 2022
Journal Name
Webology
Ethical Perception of Leadership and Responsible Behavior: An Exploratory Study of Leaders of Public Organizations in Iraq
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The study aimed to identify the effect of the ethical perception of a sample of managers in public organizations on responsible behavior in light of the rapid changes taking place in the external environment. To achieve this, the researcher followed the descriptive analytical approach by applying a questionnaire of two parts. The first part dealt with the ethical perception according to the scale of Johnson (2015), which consisted of (22) items. The second part dealt with measuring responsible behavior, which consisted of (20) items based on the scale of Development of Ethical Behavior (Narvaez, 2006) for a sample of (125) respondents randomly chosen. The results showed that the estimation degree of managers in public governmental o

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Publication Date
Sun Jan 01 2012
Journal Name
Diyala Agricultural Sciences Journal (dasj)
(OLIGO-X) the effect of salinity of irrigation water and magnetisation and soaking Alalascorbek acid and extracted sea Your protected agriculture. DALIA in germination and growth of seedlings seeds of hybrid option
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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Global Pharma Technology
Spectrophotometric determination of loratadine in syrup and study viscosity conductivity and thermodynamic of binary mixed systems of surfactants with loratadine"
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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)
parasites of the house fly Musca domestica L. (Distera , Muscidae) in Iraq
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Eleven species of parasitic insects were recovered from puparia of house fly Musca domestica L. developing in animal dung in Baghdad during 1985-1987. Of the parasites obtained, representatives were found in five families of Hymenoptera and one family of Coleoptera. The most prevalent parasites were Spalangia cameroni Perkins, S. nigroaenea Curtis and S. endius Walk. Average parasitism for the two year was 11.30 %, the highest number of parasitism occurred in May and October.

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Publication Date
Mon Feb 18 2019
Journal Name
Iraqi Journal Of Physics
The evaluation of left ventricle stiffness index in patients suffering from hypertension
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Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (Ea

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Publication Date
Thu Jul 01 2021
Journal Name
Review Of International Geographical Education (rigeo)
Walkability as one of the Planning Treatments to Face Epidemics in Cities
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Walkability as one of the Planning Treatments to Face Epidemics in Cities

Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
The Image of Women in Arab Media Advertisements: معجب بن عثمان الزهراني
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Advertisements containing images of women represent one of the most controversial topics of the advertising industry and has an impact on people and trends. This study aims to determine the typical mental image of women purveyed through visual advertising in the Arab media. It also aims to find out whether these advertisements portray women positively or negatively, in addition to investigating the reasons for the recent negative portrayal of women in commercials. The study adopted a descriptive-analytical approach to achieve these objectives. The results indicate that advertising designs that carry images of women displayed in the Arab media create strong mental images. Repetition reinforces these images, and they emphasize the concept

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