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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
Fri Jan 02 2015
Journal Name
Desalination And Water Treatment
Effect of pH on the performance of olive pips reactive barrier through the migration of copper-contaminated groundwater
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Publication Date
Sat Apr 30 2022
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
Effect of exercises on the VertiMax device on the endurance of under 16-years of age discus throwers
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The primary aim of the present study was to prepare a set of exercises on the multi-resistor VertiMax device and to identify the effect of these exercises on the development of the endurance of discus throwers under 16 years old. The design of the present study was experimental. Participants were selected using purposive sampling method. A total of 5 discuss players constituted the sample of the study. The authors found a significant improvement in the levels of endurance and performance as a result of the training on the VertiMax device. Therefore, it is recommendable to use exercises on the VertiMax device to improve the endurance and performance of under 16-years of age discus throwers.

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Publication Date
Wed Jun 01 2022
Journal Name
Baghdad Science Journal
Impact of Hindiya Dam on the Limnological Features of Euphrates River to the North of Babil Governorate, Iraq
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          Five sites were chosen to the north of Babil Governorate in   order to identify the limnological features and the impact of the Hindiya Dam during 2019. Site2 was located near the dam to reflect the ecological features of this site, whereas other sites, S1 was located at the upstream of the dam as a control site. Moreover, the two other sites S3 and S4 were located down the dam. The results of  the  study  showed  a  close  correlation  between air and water temperature at all sites. Also there were significant differences in average of thirteen out of eighteen water parameters.Water temperature, total alkalinity, bicarbonate, DO, POS, TH and Mg+2  ions  decreased from 22.76˚C, 203.33 mg/L,

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Multiple Intelligences on the Acquisition of Science Operations by Middle School Students of Arabic Grammar
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The current research aims to identify the multiple intelligences in the fourth students’ acquisition of the literary processes of Arabic grammar and to identify the differences in multiple intelligence according to gender (males - females). The study was determined for students of the fourth literary preparatory Al-Hakim Preparatory (for males) and Rabat Preparatory (for females) of the Second Karkh Education Directorate, topics from the Arabic grammar subject (past tense, present tense, imperative, subject, and object) for the first semester of the academic year 2019-2020. The results showed that there were no statistically significant differences at the significance level (0.05) between the average scores of the students who were tau

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Publication Date
Thu Aug 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Effect of the application of IFRS 15 "Revenue from contracts with customers" on the quality of financial reporting
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Abstract

This study aims at identifying the impact of the application of IFRS 15 "Revenue from contracts with customers on the quality of financial reporting, through application to faculty members in the accounting departments of Iraqi universities and auditors. The problem of the study was the multiplicity of accounting rules and standards Which deals with the issues of revenue recognition , as well as the lack of consistency of most of them with the common framework of financial accounting, which results in low quality of financial reporting in the current financial statements, where the formulation of one hypothesis was the lack of relationship of significant significance The application of IFRS 15 "Recognition of rev

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Publication Date
Sun Sep 02 2018
Journal Name
Arab Journal Of Basic And Applied Sciences
Development of the Banach contraction method for the solution of nonlinear thin film flows of non-Newtonian fluids
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Publication Date
Mon Aug 31 2020
Journal Name
Journal Of Research In Medical And Dental Science
The Effect of Super Oxidized Water Mouthwash on the Level of IL 1? in Gingival Crevicular Fluid for Patients with Gingivitis Randomized Clinical Trial
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Background: One of the most predominant periodontal diseases is the plaque induced gingivitis. For the past 20 years, super-oxidized solutions have be..

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of National Standards for Exposure to Chemical Materials and Dusts in the State Company for Drugs Industry in Samarra
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Objective: Evaluation the national standards for exposure to chemical materials and dusts in The State
Company for Drugs Industry in Samarra.
Methodology: A descriptive evaluation design is employed through the present study from 25th May 2011
to 30th November 2011 in order to evaluate the national standards for exposure chemical materials and dusts
in The State Company for Drugs Industry in Samarra. A purposive (non-probability) sample is selected for the
study which includes (110) workers from the State Company for Drugs Industry in Samarra. Data were
gathered through the workers` interviewed according to the nature of work that they perform. The evaluation
questionnaire comprised of three parts which include the w

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Publication Date
Sat Jun 04 2022
Journal Name
Journal Of Inorganic And Organometallic Polymers And Materials
Improving the Mechanical Properties, Roughness, Thermal Stability, and Contact Angle of the Acrylic Polymer by Graphene and Carbon Fiber Doping for Waterproof Coatings
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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The instrumental support search strategies and avoid coping to psychological stressors and their relationship to the cognitive motivation of Al-Anbar University students.
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the Current research aims to identify the psychological stressors coping strategies and their relationship to the cognitive motivation among Al-Anbar University students through the following hypotheses: 1) no statistically significant differences at a level (0.05) among the sample according to the instrumental support strategy depending on the variable type and specialization, 2) No statistically significant differences at a level (0.05) among the sample in regard of coping avoiding strategy depending on the variable type and specialization, 3) There is no statistically significant difference at a level (0.05) in cognitive motivation level among Al-Anbar University students, 4) No statistically significant differences at a level (0.05)

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