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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
Mon Nov 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The role of topical application of bone morphogenetic protein 7 (BMP7) on bone healing on rabbits (Immunohistochemical study on TGF-β 3 & IGF-1R)
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Background: Bone is essentially a highly vascular, living, constantly changing mineralized connective tissue. It is remarkable for its hardness, resilience and regenerative capacity, as well as its characteristic growth mechanisms. This study aimed to: 1. To evaluate the effect of bone morphogenetic protein7 (BMP7) on bone healing in artificially created intrabony defect in rabbits upper diastema, histologically. 2. To study the immunohistochemical expression of TGF-β3 and IGF-1R as bone formation markers in experimental and control groups during bone healing. Material and method: Forty male rabbits, was used in this study, 8 rabbits for each healing interval (3 days, 1,2 ,4 and 6 weeks). In each rabbit two bone holes were created on th

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Publication Date
Mon Sep 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Modeling of a Sulfonation Reactor in a Detergent Factory
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Publication Date
Wed May 03 2017
Journal Name
Arab Conferences Network / American Research Foundation
Understanding the nature of science among chemistry teachers according to the AAAS document for the Educational Reform Project 2061
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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Bayesian Estimation for The Shape Parameter of The Power Function Distribution (PFD-I) to Use Hyper Prior Functions
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The objective of this study is to examine the properties of Bayes estimators of the shape parameter of the Power Function Distribution (PFD-I), by using two different prior distributions for the parameter θ and different loss functions that were compared with the maximum likelihood estimators. In many practical applications, we may have two different prior information about the prior distribution for the shape parameter of the Power Function Distribution, which influences the parameter estimation. So, we used two different kinds of conjugate priors of shape parameter θ of the <

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Publication Date
Mon Oct 30 2023
Journal Name
Rare Metal Materials And Engineering
The effect of special exercises using the (Blazepod) device to develop the defensive player's movement for advanced basketball players
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The purpose of this paper is to preparing exercises for using the (Blazepod) device for advanced basketball players, and then identifying the effect of using the (Blazepod) device in developing some of the player's defensive movement for advanced basketball players. 12 players from the Adhamiya Sports Club, the category of applicants for the 2022/2023 sports year, where they were chosen in a deliberate manner from the community of origin represented by clubs, and the researchers used the defender player's movement test, and the results of the study showed that the special exercises prepared by the researcher using the (Blazepod) device affected the development Defensive skills (the movement of the defending player) greatly increased among a

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Improvement the bearing capacity of the soil which is supporting the shallow foundation by using bored short micro-piles
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In this paper , concrete micro-piles were used to improve the bearing capacity of the soil which is supporting the shallow foundation by using groups of (4; 6 and 9)bored short micro-piles which have, (D=0.125m and D=0.1m), and length to diameter ratio (L/D) equal to (6; 10 and 12) respectively. To calculate the bearing capacity of the micro-piles,(Tomlinson) and (Lamda) methods were used; also the soil properties were taken from Al-Muthana airport,(Al-Qyssi,2001) [1]. The results show that; increasing the number of piles and/ or the diameters and lengths; and the interaction between the bearing capacity of the shallow foundation with the bearing capacity of the pile group which leads to increasing the strength against the external loads

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
THE EFFECT OF SPREACL of KNOWLEDGE ON ETHICS
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THE EFFECT OF SPREACL of KNOWLEDGE ON ETHICS

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
new Estimator of the parameter of negative exponential
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the main of this paper is to give a comprehensive presentation of estimating methods namely maximum likelihood bayes and proposed methods for the parameter

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Publication Date
Fri Jan 05 2024
Journal Name
Al-academy
Designs treatment of the internal spaces of pharmacies
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The pharmacy is the face for the health buildings and hospitals, The linking professional relationships and functional, it is been from the important places that most people go it, so according to that we must format its interior design in form that suitable with the need of most people use it or work in it, and this the search goal, dashing from the search subject which to hide finding designer treatment for the pharmacies interior spaces, to give share in the functional improvement performance or aesthetic. We define the search goals to share in educate the pharmacist in the effect of interior design for improvement of interior environment, in addition to the search consider as designer trying add to the other trying the interior desig

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Publication Date
Wed May 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Urban renewal of the historic centre of Rusafa
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Abstract<p>The historical centers represent the present of the past, which is embodied in its buildings and spaces, which are places of continuous life bearing the history of the city with all its material and objective dimensions, making it living centers that form an essential part of the body of the city and give it a vision for another time and it represents a cultural heritage that should be preserved and maintained. The research started from the reality that indicates the great change in the land uses of the region and the deterioration of the situation and change in use in addition to the neglect of its role and historical status, the study aims to study the subject of urban renewal of he</p> ... Show More
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