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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
Thu Oct 01 2009
Journal Name
Iraqi Postgraduate Medical J
Scarring and none scarring facial Acne vulgaris and the frequency of associated skin diseases
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S Khalifa E, AH Khalil I, N Adil A, AB Razan A…, 2009

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
Illiteracy and its Impact on the Reality of Iraqi Youth between Heritage and Contemporary
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Illiteracy has spread in the last years, although it was eliminated in the 1980s. The return of illiteracy brings ignorance, illness, backwardness and regression among nations. It has taken many types, mainly alphabetical, scientific and computer illiteracy. Hence, the increasing nature of illiteracy has attracted the attention of governments and societies alike. This may touch the reality of societies starting with their youth unless those, who are in charge, will find workable solutions for the existing problems. The results of the study revealed that there is a real disaster awaiting the next generation after years of stray, and ignorance of the people in charge who are too engaged in getting their privileges to care about this proble

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Synthesis and Evaluating the Antimicrobial Activities of Various Adducts Prepared from Isatins and Proline
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characteristic tissues and cells, exerting their pharmacological aspects and alleviating a lot of diseased processes. Accordingly, this research is about introducing some isatins to be nucleophilically attacked at C3 forming products of azomethine ylide functionality. These iminium compounds were made by allowing certain isatins to be reacted with the secondary amino acid, proline, at acetic acid and methanol medium and then collected after purification to be identified with total Leukocyte count (TLC) and melting point. The structural characterization was performed by fourier-transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (1H-NMR), and community health nursing (CHN) analysis. The microbiological evaluatio

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Publication Date
Wed Feb 15 2023
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
Instructional Design According to the Repulsive Learning Model and its Impact on the Achievement of Chemistry and Lateral Thinking for Third-Grade Intermediate Students
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Identify the effect of an educational design according to the repulsive (allosteric) learning model on the achievement of chemistry and lateral thinking. The sample consisted of (59) students from third-grade intermediate students. They were randomly distributed into two groups (experimental and control), and the equivalence was done in (chronological age, previous achievement in chemistry, intelligence, lateral thinking). The (30) students from experimental group were taught according to the instructional design, other 29 students from the (control) group were taught according to the usual method. Two tests done, one of them is an achievement test consisted of (30) items of the type of multiple choice, the other was a lateral think

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Publication Date
Fri Mar 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of Performance of Air Filters in Public Shelters
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Publication Date
Mon Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using Lean Accounting in Simplifying and Modifying Financial Reports (Focus on Value Stream): A practical Study in AL- Hayat Soft Drinks and Mineral Water Company
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With the advent of the globalization, the rapid development in technology and the intensity of competition companies attemptto maintain competition advantages and retain customers. The traditional methods in managerial accounting become irrelevance to achieve the objectives of these companies especially with the rapid changes in modern manufacturing environment .Thus there is a need to new tools in accounting such as lean accounting, which is considered as a costing method that support creating value for the customer by costing the entire value stream, eliminating waste in the accounting process, reduced lead time, improved quality, lowered time delivery and increased available capacity. Using value stream focuses not only on the waste&n

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Publication Date
Mon Jan 01 2018
Journal Name
Int. J. Agricult. Stat. Sci. V
The role of irrigation management processes and micronutrient fertilization on parameter of growth and yield of two wheat varieties
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The experiment was conducted in Al- Mahaweel Research Station in Babel Governorate, Ministry of Agriculture during autumn season 2016-2017 to determine the role of irrigation management processes and micronutrient fertilization in growth and productivity of two varieties of wheat IPA 99 and Al-Rasheed 22 in clay loam soil classified as Typic Torriflovent. The experiment included four irrigation treatments and six fertilization treatments. The experiment was designed under randomized complete block design (RCBD) with three replications. Wheat grain IPA 99 and Al-Rasheed 22 varieties were planted in 23/11/2016 and harvested in 13/5/2017. The amount and periods of irrigation depended on sensors reading of volumetric water content was measured

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Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Expressing the Bewilderment of the Modern Man through Silence in Samuel Beckett’s Happy Days: بسعاد ماهر محيل, ومنذر عبد الرزاق سبع
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Samuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
The Protective Effect of Radish (Raphanus sativus) Seeds Against the Oxidative Stress Induced by Sodium Nitrite in Male Rabbits (Oryctolagus cuniculus)
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The aim of this study is to investigate the protective effect of Radish (Raphanus sativus) seed alcoholic extract 70% against oxidative stress induced by sodium nitrite NaNO2 Twenty five adult male rabbits were devided into five groups of (five rabbits in each group) and treated daily for 30 days. Group T1: intubated orally 20 mg/kg NaNO2, Group T2: intubated orally 20 mg/kg NaNO2 + 50 mg/kg of alcoholic extract from Raphanus sativus seeds, Group T3: intubated orally 20 mg/kg NaNO2 + 100 mg/kg of alcoholic extract from Raphanus sativus seeds, Group T4: intubated orally 20 mg/kg NaNO2 + 200 mg/kg of alcoholic extract from Raphanus sativus seed as well as Group C: control intubated orally distilled water. In comparison with normal ra

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Degree to which Islamic Education Teachers Employ the Strategy of Directed Discovery in Teaching to Develop Higher-Order Thinking Skills
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The study aimed to know the degree to which Islamic education teachers employ the strategy of directed discovery in teaching to develop higher thinking skills (analysis, synthesis, and evaluation) among sixth-grade students at the basic stage in East Nile Province, Khartoum State - Sudan. The researcher used the descriptive-analytical method, and adopted a questionnaire that consisted of (15) indicators representing the skills of analysis, synthesis, and evaluation as a tool of the study. A random sample of (175) Islamic education teachers was selected, from the Department of Basic Education. The data were analyzed according to the Statistical Packages for Social Sciences (SPSS) program, and the results of the study have shown that the u

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