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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
Sat Jan 01 2022
Journal Name
Annals Of Biology
The Comparative Effect of Copper Oxide Nanoparticles and Copper Sulfate on Reproductive Hormones and Sperm Parameters in Mature Male Albino Mice
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Publication Date
Fri Jan 01 2021
Journal Name
Brazilian Dental Science
Assessing the level and diagnostic accuracy of osteopontin and oral health status in periodontitis patients with/without Type-2 Diabetes Mellitus
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Publication Date
Tue Jan 01 2013
Journal Name
Uob
Effect of Irrigation Levels and Organic Matter in The Growth, Yield and its Quality for Chilli Pepper Under Organic Farming System
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Publication Date
Sun Apr 14 2024
Journal Name
Plant Archives (09725210)
Effect of addition of organic and chemical fertilization and spraying of alpha tocopherol on the growth and yield of tomato (Solanum lycopersicum mill.).
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Publication Date
Sat Aug 01 2015
Journal Name
International Journal Of Science And Research
Bacteriological and Immunological Study of Rheumatoid Arthritis
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The current study included the collection of 175 samples of blood (Urea-blood) of patients with rheumatoid arthritis from Al–Al-Kindy Teaching Hospital, Baghdad Teaching Hospital and Al-Imamian Al-Kadhimyain Medical City in Baghdad from both sexes with different ages at the period between 1/10/2016-1/2/2017. Bacterial growth results showed that 80% of urea for bacterial transplantation were positive results, while the number of samples showing no bacterial growth was 20%. The bacterial isolation evaluate for morphological testes and biochemical microscopy, as well as identification by Api system. The highest frequency of inflectional bacteria was E. coli (41.97%), followed by E. cloacae (21.25%), P. aeruginosa (12.5%), Salmonella (10%), K

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Publication Date
Tue Jul 01 2014
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
MORPHOLOGICAL AND ANATOMICAL STUDY OF ASPHODELUS MICROCARPUS
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    The genera and species of Liliaceae show a considerable structural diversity of leaves and especially stems. This paper presents a morphological and anatomical study of the leaves and stems of Asphodelus microcarpus. The results showed that the investigated species had typical morphological characters. and also that it could be distinguished from another plant not only by its morphological but anatomical characters as well.

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Publication Date
Fri Jun 01 2012
Journal Name
Pharmacie Globale
Synthesis and microbiological study of new sulfonamides
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In contrast to the classical antibacterial sulfa drugs that are unsubstituted or monosubstituted, our newly synthesized analogs were designed to obtain sulfonamide moiety containing disubstituted hetero nitrogen atom. These compounds were formed successfully by chlorosulfonation of acetanilide and the product was treated with different cyclic amines and finally amide hydrolysis was necessary to get agents that were analyzed for IR, UV, CHN, melting points and solubility. At last, we studied their antibacterial activity on certain types of bacteria and we noticed the inactivity due to possible steric factor. Principly, this means these products have no inhibiting action against the used microbes.

Publication Date
Thu Feb 13 2020
Journal Name
College Of Islamic Sciences
سيا Contextual study of faces and isotopes
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This is a contextual study in face and isotope science, and I have made it in one of the terms faces and isotopes, which is the word (bad). Quranic also, and that is at every aspect they mentioned.
The nature of the research required that it be divided into three sections:
The first topic: I singled it out to show the types of contextual connotations.
- The second topic: I singled it out to define the word bad and its meaning.
- The third topic: I devoted it to the study of the word bad and explaining the significance of the Quranic context on the additional meaning and the original meaning.
Conclusion: It mentioned the most important results, which are:
1- The significance of the Quranic context is one of the most impo

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Publication Date
Mon May 27 2019
Journal Name
Al-academy
Problems of Social Networking Sites in Nurturing the Aesthetic Taste of Teenagers: زهراء صبحي خزعل
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With the growing number of Internet users, public and private arts activities have become increasingly popular. Adolescents have begun to establish aesthetic taste and new cultural values. This category is the most affected one by the published images and ideas especially in the social networking space and specifically the Facebook. It is the most important problem in their cultural composition. This research aims to detect the problems of social networking sites in nurturing the aesthetic taste of adolescents. The researcher used the analytical descriptive approach to obtain accurate information describing the current situation or depicting the social reality of adolescents. The research concluded that the public discourse in social med

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
Meaning of formulation غ more actions      In Surat Al-Baqarah at the pride of honor
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Praise be to God, who started his book with the praise of himself and prayers and peace be upon those who do not have a prophet after him and his family and companions and those who followed them with charity until the Day of Judgment. Either:
      The research examines the meanings of the formulas of the increased verbs that were mentioned in Surat Al-Baqara, at the imam of the imams of the Islamic nation, namely, Al-Fakhri Al-Razi (d. 606 AH), may God Almighty have mercy on him. With the imams of Quranic scholars.

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