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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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Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Activity, Profitability Indictors Analysis: A Comparsion Study among Nationality and Iraqi Insurance Company
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Reseach target the most important topic, is Activity and ProfitabilityIndictors Analysis for
Nationality and Iraqi Insurance Company, In order to stand on them ability to cover its risks
and explore the efficiency asset and its avialible resources using to determine them abilities to
profit generation from its insurance activity. The analysis was focus to examine their profit
and activity power, and test the significant differences aming them performance. Test 2
hypothese that is related and result it sign that the 2 company no has significant differences at
profitability and activity level. The research depend on coneclusion, recommended two
company to work at efficiency with cost element of insurance activity in or

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Publication Date
Tue Apr 30 2024
Journal Name
Iraqi Journal Of Science
Topology-Based Modularity and Modularity Density for Detecting Protein Complexes: A Comparative Study
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     Binary relations or interactions among bio-entities, such as proteins, set up the essential part of any living biological system. Protein-protein interactions are usually structured in a graph data structure called "protein-protein interaction networks" (PPINs). Analysis of PPINs into complexes tries to lay out the significant knowledge needed to answer many unresolved questions, including how cells are organized and how proteins work. However, complex detection problems fall under the category of non-deterministic polynomial-time hard (NP-Hard) problems due to their computational complexity. To accommodate such combinatorial explosions, evolutionary algorithms (EAs) are proven effective alternatives to heuristics in solvin

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Publication Date
Fri Jun 30 2023
Journal Name
Pakistan Heart Journal
Workplace Violence and Nursing Job Performance at Pediatric Emergency Departments: A Comparative Study
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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Personal tax exemptions "a comparative study with some Arab and European system legislations
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This research aims primarily to highlight personal tax exemptions A comparative study with some Arab and European regulations. And by conducting both theoretical comparative analyses. Most important findings of the study is the need to grant personal and family exemptions that differ according to the civil status of the taxpayer (single or married). In other words, the exemption increases as the number of family members depend on its social sense. Also taking into account some incomes that require a certain effort and looking at the tax rates, it is unreasonable for wages to be subject to the same rates applied to commercial profits.      

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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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Publication Date
Mon Dec 01 2014
Journal Name
Agricultural Mechanization In Asia, Africa And Latin America
Determination of the suitability period of S-3 diesel oil when used in tractor engines
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The diesel oil type S-3 specified for diesel engine has limited the suitability for diesel trucks for 8000 km, but didn't clarify its suitability if used in tractor engines.It is known that the work style of farm tractor differs from that of other vehicles where tractors are used for all the activities in sever conditions and under the complete usage of the available power and capability, so there is no sign or indication of the usage period of this oil in tractor's engine. The oil has been used on Cirta C6806 tractors. The manual book of the tractor's engine, Deutz recommends changing the oil every 100 hrs. Therefore the main goal of this research is to give the recommended working hours for S-3 diesel oil when used in farm tractor engines

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