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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 Dec 10 2007
Journal Name
Iraqi Journal Of Laser
The Effect of He:Ne Laser on Viability and Growth Rate of Leishmania Major
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An isolate of Leishmania major was grown on the semisolid medium and incubated at 26ºC. The isolate was irradiated by He: Ne laser (632.8 nm, 10 mW) at exposure times (5, 10, 15, 20, 25, 30) minutes in their respective order. The unirradiated groups represent control group. Growth rate and percentage of viability were examined during six days after irradiation. The change in these two parameters reflects the effect of irradiation on the parasite. The results refers that the general growth effected by irradiation in comparison with un irradiation group, The growth rate of parasite decrease with increasing the exposure time in comparison with control group. Parasite viability decrease with irradiation and the percentage of living cell dec

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
TOXOPLASMOSIS, DIABETES AND SOME IMMUNE FACTORS THAT EFFECT ON THE BURDEN OF PATIENTS’ IMMUNITY
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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
Effect of Partial Coherence illuminated bar on evaluation technique of diffraction image
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In this work, we are obviously interested in a general solution for the calculation of the image of a single bar in partially coherent illumination. The solution is based on the theory of Hopkins for the formation of images in optical instruments in which it was shown that for all practical cases, the illumination of the object may be considered as due to a self – luminous source placed at the exit pupil of the condenser , and the diffraction integral describing the intensity distribution in the image of a single bar – as an object with half – width (U0 = 8 ) and circular aperture geometry is viewed , which by suitable choice of the coherence parameters (S=0.25,1.0.4.0) can be fitted to the observed distribution in various types of mi

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Preparation and identification of oxidatin derivaties for Salts and acids of bile for medical uses
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The purified prepared compounds were identified through different methods of identification i.e, I.R, UV-vi^ble-spectroscopy in addition to (coloured tests) Calculation of the sum of OH groups. TLC techniques were also used to test the purity and the speed ofthe rate of flow (RF).

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Publication Date
Thu Apr 14 2022
Journal Name
Nat. Volatiles & Essent. Oils,
Estimate The Amount of Amino and Fatty Acids in The Liver Tissue of Uromastyx Aegyptius Microlepis During the Periods of Hibernation (December) And Activity (May)
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Amino and fatty acids in the liver tissue of Uromastyx aegyptius microlepis during the periods of hibernation (December) and activity (May) were estimate by a high performance liquid chromatography, liver of a lizard during the activity and hibernation seasons, contained 18 amino acids, which include, 10 essential amino acids and 8 non-essential amino acids, and the liver in the male lizard contained five fatty acids during each season, the concentration rates of all the amino acids during the activity season were higher than their counterparts during the hibernation season, the total concentrations of essential and non-essential amino acids during the activity season were 19434.8 µg/ml, which was greater than the total concentrations leve

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Publication Date
Thu Feb 01 2024
Journal Name
Journal Of Thermal Analysis And Calorimetry
Heat transfer and fluid flow characteristics over a backward-facing step (BFS) containing square-rectangular ribs integrated as forward-facing steps (FFS)
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Publication Date
Sun Jan 01 2017
Journal Name
Pakistan Journal Of Biotechnology
Fragmentation of gallbladder stones using transformer streptococcus salivarius and measuring of RNA expression to cholesterol lowering genes
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Recently, gallbladder stones have been contained bile salt saturated a proximal 70 % cholesterol. This led us to investigate how can use transformer Streptococcus salivarius with plasmid pMG36bsh to fragment cholesterol of gallstones in vitro. Total mRNA of S. salivarius was produced using easy-spinTM, total RNA extraction kit and PCR cDNA-RT to observe the change after percent pMG36bsh vector and prepare S. salivarius have two copies from bsh genes (cgh, bsh) to fragment gallstone in bacterial culture. Our data shows increase bacterial bsh expression help to reduce gallstones concentration in culture when bile salt presented as stimulating agent for the association bsh genes were 77% compare with wild type has the reducing concentration ra

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Publication Date
Thu Oct 15 2020
Journal Name
Iop Conf. Series: Journal Of Physics: Conf. Series
Estimate the Rate of Contamination in Baghdad Soils By Using Numerical Method
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The aim of this paper is to evaluate the rate of contamination in soils by using accurate numerical method as a suitable tool to evaluate the concentration of heavy metals in soil. In particular, 2D –interpolation methods are applied in the models of the spread the metals in different direction.The paper illustrates the importance of the numerical method in different applications, especially nvironment contamination. Basically, there are many roles for approximating functions. Thus, the approximating of function namely the analytical expression may be expressed; the most common type being is polynomials, which are the easy implemented and simplest methods of approximation. In this paper the divided difference formula is used and extended

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Publication Date
Thu Nov 14 2019
Journal Name
Journal Of Physics: Conference Series
Estimate the Rate of Contamination in Baghdad Soils By Using Numerical Method
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Journal of Physics: Conference Series PAPER • THE FOLLOWING ARTICLE ISOPEN ACCESS Estimate the Rate of Contamination in Baghdad Soils By Using Numerical Method Luma Naji Mohammed Tawfiq1, Nadia H Al-Noor2 and Taghreed H Al-Noor1 Published under licence by IOP Publishing Ltd Journal of Physics: Conference Series, Volume 1294, Issue 3 Citation Luma Naji Mohammed Tawfiq et al 2019 J. Phys.: Conf. Ser. 1294 032020 DOI 10.1088/1742-6596/1294/3/032020 DownloadArticle PDF References Download PDF 135 Total downloads 88 total citations on Dimensions. Turn on MathJax Share this article Share this content via email Share on Facebook (opens new window) Share on Twitter (opens new window) Share on Mendeley (opens new window) Hide article and author

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Publication Date
Thu Aug 31 2023
Journal Name
Journal Of Kufa For Mathematics And Computer
Four Points Block Method with Second Derivative for Solving First Order Ordinary Differential Equations
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