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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 Jan 01 2019
Journal Name
Indian Journal Of Public Health Research &amp; Development
Comparison of the Cyclic Fatigue of Protaper Next, 2Shape and Hyflex EDM Using Glyde
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Publication Date
Fri Jan 01 2016
Journal Name
Iraqi Journal Of Agricultural Sciences
Effect of sheep manure extract on the growth and nutrients content of tomato seedlingss
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Publication Date
Thu Apr 21 2016
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECT OF SHEEP MANURE EXTRACT ON THE GROWTH AND NUTRIENTS CONTENT OF TOMATO SEEDLINGS
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The experiment was conducted under shading (with the aid of Saran) condition on a nursery managed by the Baghdad Mayoralty during the season of 2014-2015 to study the effect of composed sheep manure extract on the growth and leaf nutrients content of tomato seedlings var. Wijdan. The experiment was composed of 6 treatments included the extract of sheep manure by hot (425C)and lmbient(205C) temperature water .The extract was diluted to the half by water and foliar applied to seedlings (multible application) or to the soil . Treatments also included the application of NPK chemical fertilizers as recommended and a control treatment through applying distilled water as foliar .The experiment was designed according to the randomized compl

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Publication Date
Thu Jan 09 2014
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci.
Effect of Thickness on the Electrical Conductivity and Hall Effect Measurements of (CIGS) films
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The influence of different thickness (500, 1000, 1500, and 2000) nm on the electrical conductivity and Hall effect measurements have been investigated on the films of copper indium gallium selenide CuIn1-xGaxSe2 (CIGS) for x= 0.6.The films were produced using thermal evaporation technique on glass substrates at R.T from (CIGS) alloy. The electrical conductivity (σ), the activation energies (Ea1, Ea2), Hall mobility and the carrier concentration are investigated and calculated as function of thickness. All films contain two types of transport mechanisms of free carriers, and increases films thickness was fond to increase the electrical cAnductivity whereas the activation energy (Ea) would vary with films thickness. Hall Effect analysis resu

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Publication Date
Tue Jan 08 2019
Journal Name
Iraqi Journal Of Physics
Effect of thickness on the structure, morphology and A.C conductivity of Bi2S3 thin films
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Thin films samples of Bismuth sulfide Bi2S3 had deposited on
glass substrate using thermal evaporation method by chemical
method under vacuum of 10-5 Toor. XRD and AFM were used to
check the structure and morphology of the Bi2S3 thin films. The
results showed that the films with law thickness <700 nm were free
from any diffraction peaks refer to amorphous structure while films
with thickness≥700 nm was polycrystalline. The roughness decreases
while average grain size increases with the increase of thickness. The
A.C conductivity as function of frequency had studied in the
frequency range (50 to 5x106 Hz). The dielectric constant,
polarizability showed significant dependence upon the variation of
thic

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Publication Date
Fri Nov 14 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of canal dryness and flaring on the accuracy of two electronic apex locators
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Background: This in vitro study evaluated the effect of canal dryness and flaring on the accuracy of two electronic apex locators for working length (WL) determination. Materials and methods: Sixty extracted teeth were used, after access opening was done, the occlusal surface was flattened to create stable reference point. The teeth were randomly divided into two equal main groups of flared and unflared group each one of 30 teeth. The flaring was done with Gates Glidden drills. The two main groups were further subdivided into two subgroups: dry canal and wet canal using 5.25% sodium hypochlorite groups, Electronic WL of each sample was determined using both Root ZX and i-Root apex locator. Consequently, histologic WL was determined by shav

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Publication Date
Fri Mar 28 2025
Journal Name
Medicni Perspektivi
THE IMPACT OF VARYING INTENSITIES OF MAGNETICALLY TREATED WATER ON RENAL AND TESTICULAR TISSUE
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Publication Date
Thu Jul 25 2019
Journal Name
The Eurasia Proceedings Of Science Technology Engineering And Mathematics
Impact of the Chemical Mutagenesis on Biomass and Productivity of some Micro Green Algae
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The Eurasia Proceedings of Science Technology Engineering and Mathematics | Volume: 6

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Engineering
Effect of Heat Treatments and Carbon Content on the Damping Properties of Structural Steel
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Low- and medium-carbon structural steel components face random vibration and dynamic loads (like earthquakes) in many applications. Thus a modification to improve their mechanical properties, essentially damping properties, is required. The present study focuses on improving and developing these properties, significantly dampening properties, without losing the other mechanical properties. The specimens used in the present study are structural steel ribbed bar ISO 6935 subjected to heating temperatures of (850, 950, and 1050) ˚C, and cooling schemes of annealing, normalizing, sand, and quenching was selected. The damping properties of the specimens were measured experimentally with the area under the curve for the loadi

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Publication Date
Tue Dec 20 2022
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ECOLOGY OF LEECHES AND GASTROPODS OF THE LOWER AK-BUURA RIVER, FERGANA VALLEY,UZBEKISTAN
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This study was conducted on species composition, morphology, ecological characteristics, biotope distribution, ecological groups, biodiversity indicators and zoogeography of leeches and gastropods distributed in the lower Ak-Buura River. According to the results, it was found that 7 species of leeches belonging to 4 families and 6 genera and 10 species of fresh-water gastropods belonging to 3 families and 6 genera live in the lower Ak-Buura River. In the river, it was observed that leeches are mainly distributed in muddy biotopes, and gastropods are widespread in muddy, stony and sandy biotopes with a lot of plants. Biodiversity indices of leeches and gastropods in the Ak-Buura River were analyzed using the Shannon index. As a result, it

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