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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 Jan 01 2018
Journal Name
Journal Of Pharmacy Research
Design and in vitro characterization of bisacodyl as a hollow-type suppositories
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Publication Date
Thu Aug 01 2024
Journal Name
Journal Of Engineering Research
Design, analysis and development of a proton exchange membrane in fuel cell
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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Medical evidence in matters of proof between Sharia and law: A model
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Praise be to God, prayer, and peace be upon the Messenger of Allah and his God and his companions. The field of the judiciary to prove or invalidate some cases in the field of proof of descent and attachment to the plaintiff or exile, and other legal and judicial issues, especially in this era where the spread of previously unknown evidence, such as DNA, which was discovered in 1953, and the genetic fingerprint discovered 1984, blood analysis and a Saliva, sweat, poetry, etc. in the field of forensic evidence, in forensic medicine or medical expertise, it can be used to identify the killer, or verify his identity, using all the evidence in the scene, such as a point of blood or sweat, and the like So, as well as to prove the lineage is u

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Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of value stream costs in rationalizing quality costs: applied research in taji mill
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The research aims to study the importance of applying lean accounting techniques and the tools and methods they contain, the most important of which is the “value path costs” technique and its impact on rationalizing and controlling costs, as well as reducing production costs in general and reducing quality costs in a way Special by reducing or eliminating waste and waste in both time and resources and meeting customer requirements. In order to achieve this goal, the researcher relied on the application of lean accounting tools by obtaining data related to the mill, in addition to that, the information obtained as a result of field coexistence in the mill and being able to view the records of the mill in the research sample. From the

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Investigation of Some Phytochemical Compounds Found in Anchusa strigosa L. Grown Naturally in Iraq
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Anchusa strigosa L.: Hardy annual biennial or perennial herb, with hairs especially on the leaves., flowers generally regular. Commonly named (Lisan Althour) in Iraq, from Boraginaceae family. The plant contains phenolic acids, flavonoids, alkaloids, sterols, and terpenoids. The Whole plant part defatted with n-hexane for 24 hours. The defatted plant material extracted using absolute methanol by Soxhlet apparatus for 24 hours, the extract fractionated by solvents of different polarity: petroleum ether- chloroform - ethylacetate- and n-butanol respectively. The n-butanol fraction hydrolyzed with 10% HCl for 5 hours by reflex to break down the glycosidic linkage. Rosmarinic acid, caffeic acid, genistein, and silybin were isolated

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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
effect work stress in performance of employees In The general company for vegetable oil industry
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This research theme of the pressures of work , which is one of the important topics in order to recognize the reality of( influencing the pressures of work in the performance of employees in the General Company for Vegetable Oil Industry in Baghdad )through the statement of the existence of the correlation and influence whether or not the statement of the strength of this relationship and its impact in the case of its existence has been provided as part of my Search for variables and their removal in front of the Sub- scientific aspect has been the distribution of the questionnaire on a sample of( 62) people working in the company Mint distributors on several sections where.

Formed resolution of two sets

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Publication Date
Sun May 05 2024
Journal Name
Technium Business And Management
Measuring Blue Ocean Leadership activities in public organizations: field research in the Ministry of Communications
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This study aims to identify the level of application of blue ocean leadership activities in public organizations and to build a conceptual and cognitive framework around this concept. The study adopted a descriptive-analytical approach, and the research sample consisted of (95) individuals from the senior management working at the center of the Iraqi Ministry of Communications (director general, department manager, section head). The data analysis technique used is structural equation modeling (SEM) and the Statistical Package for the Social Sciences (SPSS). The results indicate that the senior management in the Ministry of Communications is working to adopt the blue ocean leadership style through its activities, but not to the leve

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Publication Date
Tue Nov 30 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
The role of vitamin D3 in improving lipid profile in type 2 diabetes patients with
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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of TQM in promoting employee loyalty: Search exploratory In AL- Fedaa Public Company
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       The research aims to determine the principles of total quality management (commitment of senior management, product planning, customer satisfaction, process improvement) and its role in promoting employee loyalty through a sample survey of the opinions of managers in public redemption Company. Which amounted to (45) individuals adoption of the questionnaire as a tool head in collecting data and information and their responses were analyzed using several statistical methods, which included (arithmetic mean, standard deviation, correlation coefficient, and the coefficient of simple regression) depending on the program (spss). The research found a group of the most important conclusions from the presence

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Concurrent Engineering In Enhancing Strategic Performance :Applied Research in Zora Public Company
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Abstract

   This research aims to the relationship and the effect of concurrent engineering dimensions analyze (product design, process design, and supply chain design) on the dimensions of strategic performance (efficiency, and effectiveness) The research was conducted in public Zora Electrical Industries Company, on a sample of departments and officials, engineers, managers and people in the company amounted to (45) . A questionnaire was used for the purpose of data collection which has been adopted, with the use of statistical methods  via computerized system (spss) for processing data , identifying them and testing the research hypotheses. The research

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