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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
Tue Jan 01 2019
Journal Name
Annals Of Medicine And Surgery
The prevalence and correlation between subclinical hypothyroidism and gall stone disease in Baghdad teaching hospital
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Publication Date
Wed Jan 06 2021
Journal Name
Journal Of Planner And Development
Environmental dimensions and administrative mechanisms for the territory planning in Algeria, between theory and reality.
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     In front of the serious deterioration of the elements of the environment, new convictions arose the need to integrate into the global environmental concerns as being one and the issue of shared responsibility and the impact of this conviction, the evolution of the environment protection law in many countries, including Algeria. Due to the multiplicity of perceptions about the environmental result of multiple scientific disciplines, the legislative concept emerged to protect the environment, which includes prevention and rational management and conservation and restoration and repair.

    Environmental planning for the various governments and countries aims to avert disasters and achieve the

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Publication Date
Sat Aug 05 2023
Journal Name
Molecular Biology Reports
The relationship between OXT gene polymorphisms and reproductive hormones in pregnant and lactating Awassi Ewes
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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Expatriate Workers and Its Repercussions on the Economy and Labor Market in Iraq After 2003
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The demand for expatriate labor to Iraq increased after 2003 as a result of the openness that Iraq experienced, but this expatriate labor, which was requested at an increasing rate, has had economic, social, and political effects on the Iraqi economy in general, and the Iraqi labor market in particular. This is due to the high rates of unemployment, as most of these expatriate workers cause competition to local labor, and thus cause repercussions on the Iraqi economy as a whole, except for those expatriate workers coming with companies working in the oil sector. Iraq's GDP

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Publication Date
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Provisional diagnosis of clinically significant hemoglobinopathies and decision on suitability for marriage as part of the premarital screening program in Iraq: Iraqi Society of Hematology Guidelines
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Publication Date
Tue Oct 09 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
DESCRIPTIVE OSTEOLOGY STUDY OF ALBURNUS AMIRKABIRI (CYPRINIFORMES: CYPRINIDAE), A NEWLY DESCRIBED SPECIES FROM NAMAK LAKE BASIN, CENTRAL OF IRAN
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    This study was conducted to provide a detailed description of the osteology features of Alburnus amirkabiri from the Qareh Chai river, markazi province, Iran. For this purpose, eight specimens of A. amirkabiri were collected from the Qareh Chai River by electrofishing and fixed in 4% buffered formalin after anesthesia. The specimens were cleared and stained for osteological examination and its detailed osteological characterizations and differences with available osteological data of other members of the genus Alburnus were provided.

 

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Role of Ethical Leadership in Achieving Comprehensive Quality Standards in Public Education Schools in Al-Ardha Governorate
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Abstract

The aim of the research is to identify the role of ethical leadership in achieving comprehensive quality standards in public education schools in the Al-Ardha governorate. To achieve this goal, the descriptive approach was used, the researcher developed a questionnaire consisting of (35) items, divided into two sections: the first one is related to ethical leadership includes (17) items, and the second section relates to total quality management includes (18) items. The research sample consisted of (405) teachers from the stages of public education. The results showed that the level of ethical leadership practice (ethical personal characteristics, ethical administrative features, teamwork, and human rela

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Publication Date
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Study of different geostatistical methods to model formation porosity (Cast study of Zubair formation in Luhais oil field)
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Abstract<p>This study is concerned with making comparison in using different geostatistical methods for porosity distribution of upper shale member - Zubair formation in Luhais oil field which was chosen to study.</p><p>Kriging, Gaussian random function simulation and sequential Gaussian simulation geostatistical methods were adopted in this study. After preparing all needed data which are contour map, well heads of 12 wells, well tops and porosity from CPI log. Petrel software 2009 was used for porosity distribution of mentioned formation in methods that are showed above. Comparisons were made among these three methods in order to choose the best one, the comparing cri</p> ... Show More
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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Effect of Amoxicillin and Azithromycin Suspensions on Microhardness of Sliver Reinforced and Nano Resin-Modified Glass Ionomers: An In Vitro Study
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We aimed to examine the effect of amoxicillin and azithromycin suspensions on the microhardness of sliver-reinforced glass ionomer and nano-resin modified glass ionomer (GI). Method: Thirty discs (2mm height x 4mm diameter) of each type of GI were prepared, which were randomly assigned to amoxicillin, azithromycin, and artificial saliva groups. Microhardness was evaluated by Vickers hardness test before and after three immersion cycles. Results: The overall model (P < 0.001), before/after intervention (P < 0.001), intervention group (type of antibiotic) (P=0.013), and type of glass ionomer (P < 0.001) showed significant differences among study groups (P < 0.001). Post hoc test showed only non-significant before/after difference for Azithrom

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Publication Date
Mon Sep 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Additives on the Properties of Different Types of Greases
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The aim of this research is to study the influence of additives on the properties of soap greases, such as lithium, calcium, sodium, lithium-calcium grease, by adding varies additives, such as graphite, molybdenum disulfide, carbon black, corrosion inhibitor, and extreme pressure.
These additives have been added to grease to obtain the best percentages that improve the properties of grease such as load carrying, wear resistance, corrosion resistance, drop point, and penetration.
The results showed the best weight percentages to all types of grease which give good properties are 1.5% extreme pressure additive, 3% graphite, 1% molybdenum disulfide, 2.5% carbon black.
The other hand, the best weight percentage for corrosion inhibit

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