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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 Mar 13 2011
Journal Name
Baghdad Science Journal
Study of character and diversity of vegetation (cultivated plants) in Al-aaras Tourst Island / Baghdad
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Vascular plants that have been identified during the study seasons in the Island. The cultivated plants were 126 species belong to 103 genera and to 49 families of the year 2001-2002 . The natural vegetation in this Island has been subjected to a total disturbance and subsidence due to the comprehensive turbidity of the Island environment.Number of names of that natural vegetation has been mentioned in the study within the weed plants.The results of the study of the period of flowering and their attitudes show clear seasonal differences. During the cold months of winter, the number of the cultivated and the natural plants was at the rate of 15%.These kinds of flowers require high level of care to increase their numbers. While in the spring

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Environmental pollution of solid waste and methods of managing it Study in Ramadi Municipality Case
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The current research aims at finding out how to properly and correctly manage waste and solid waste and reduce the difficulties faced by all countries. However, it is becoming increasingly acute in developed cities because their economies are growing rapidly. It is necessary to identify the modern methods used in developed countries in managing wastes. The use of modern waste management techniques is a coordinated effort by international agencies within the borders responsible for them. The problem of the study can be identified in the lack of clarity of environmental management procedures in place. The importance of the research contributes to providing greater capacity to the administrative and technical leadership in the municipality

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Publication Date
Thu May 15 2025
Journal Name
Journal Of Animal Health And Production
Functional and Histological Study of Liver in Adult Rats Treated with Different Doses of Melatonin
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his study aimed to evaluate the effects of different doses of melatonin on liver function in adult rats. Eighteen Wistar adult albino rats (Rattus norvegicus), approximately 13–16 weeks old and weighing 230 ± 10 g, were randomly divided into three groups (n=6 per group) and treated orally for 30 days as follows: Group A1 received 10 mg/kg body weight (B.W) of melatonin; Group A2 received 20 mg/kg B.W of melatonin; and the control group (Group A) received distilled water. At the end of the treatment period, blood samples were collected via cardiac puncture, and serum was separated for biochemical analysis. Parameters assessed included oxidative stress markers (malondialdehyde (MDA), reduced glutathione (GSH)) and liver enzymes (aspa

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of Elongation Percentage, Tensile, and Tear Strength of Filler Particles: An In Vitro Study
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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
A Multimodal Analysis of Hyperbolic Devices in Advertisements of Health and Beauty Products
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         This paper examines the use of one of the most common linguistic devices which is hyperbole. It shows how hyperbolic devices are used as an aspect of exaggeration or overstatement for an extra effect in which the speaker can use hyperbole to add something extra to a situation in order to exaggerate his idea or speech. It is, like other figures of speech, used to express a negative or positive attitude of a specific unit of language. Thus, this paper is set against a background of using hyperbole concerning two main fields (advertisements and propaganda). So, the use of hyperbole will be implied by analyzing them concerning their meaning) literal and non-literal).  Methodology of this

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Journal Of Science
Use of Scalp Hair as a Biomarker to Determine Airborne Heavy Metal Concentrations for the Academic Laboratory Employees
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Academic chemical laboratories (ACL) are considered public places  the employees come in contact with a variety of pollutants. The aim of the current study was to detect heavy metals levels in the indoor air of ACL in two universities in Baghdad city and assess their levels in the academic employees’ scalp hair as biomarkers. Air samples inside ACL were collected to detect Fe, Cd, Zn, Pb and Cu. Scalp hair samples were collected from 40 adult chemical laboratory employees aged 30-60 years, who worked 5 days/week for 6 hours a day. Personal information relating to employees such as age, duration of exposure, smoking habit and sex, was collected as a questionnaire. The results of this study concluded that academic laboratory employ

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Biotech Research
Bacteriocin Production by Staphylococcus Epidermidis the Normal Flora of Outer Ear: A Potential Probiotic Against Outer Ear Infections
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Scopus
Publication Date
Sun Mar 01 2015
Journal Name
Current Research In Microbiology And Biotechnology
Evaluation for the Cytotoxic Effect of Exotoxin A Produced by Pseudomonas aeruginosa on Mice by using Cytogenetic Parameters
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This research was conduct to evaluate the cytotoxic effect of exotoxin A (ETA) produced by Pseudomonas aeruginosa on mice in comparison with (phosphate buffer saline (PBS) as a negative control. The effect of the toxin was measured by employing the cytogenetic analysis which included (the mitotic index (MI), chromosomal aberrations (CAs), micronucleus (MN) and sperm abnormalities) parameters. In order to specify the cytotoxic effect of the toxin, three doses of ETA (125, 250 and 500 ng/ml) were used. Results showed that ETA was found to cause a significant decrease in mitotic index (MI) percentage, while significant increase in micronucleus (MN), chromosomal aberrations (CAs) and sperm abnormalities parameters in compression with control wa

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Publication Date
Sun Jun 07 2009
Journal Name
Baghdad Science Journal
The adsorption-desorption process as a method for separation of nitrogen-carbon dioxide gas mixture using activated carbon
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Gas adsorption phenomenon on solid surface has been used as a mean in separation and purification of gas mixture depending on the difference in tendencies of each component in the gas mixture to be adsorbed on the solid surface according to its behaviour. This work concerns to study the possibilities to separate the gas mixture using adsorption-desorption phenomenon on activated carbon. The experimental results exhibit good separation factor at temperature of -40 .

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
A Comparison of Parameters Estimation Methods for the Negative Binomial Regression Model under Multicollinearity Problem by Using Simulation
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This study discussed a biased estimator of the Negative Binomial Regression model known as (Liu Estimator), This estimate was used to reduce variance and overcome the problem Multicollinearity between explanatory variables, Some estimates were used such as Ridge Regression and Maximum Likelihood Estimators, This research aims at the theoretical comparisons between the new estimator (Liu Estimator) and the estimators

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