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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
Wed May 01 2013
Journal Name
Journal Of Drugs In Dermatology (jdd)
Melanocytes Transplantation in Patients With Vitiligo Using Needling Micrografting Technique - JDDonline - Journal of Drugs in Dermatology
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AbstractBACKGROUND: Some cases of vitiligo require melanocyte transplantation, but these surgical techniques have varying degrees of success. OBJECTIVES: To perform melanocytes transplantion in patients with vitiligo using a new needling micrografting technique. PATIENTS and METHODS: This interventional case study took place at the Department of Dermatology and Venereology at Baghdad Teaching Hospital from December 2010 to September 2011. Twelve patients with vitiligo were included. A split-thickness skin graft was taken from the normal area and cut into micropieces ranging from 0.1 mm to 0.3 mm in diameter. The recipient area was anesthetized, and the micrografts were then implanted into the dermis using the needling technique. The number

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Publication Date
Mon Feb 21 2022
Journal Name
Научный форум: Филология, искусствоведение и культурология: сб. ст. по материалам Lv междунар. науч.-практ. конф. – No 1 (55). – М.
Metaphor and difficulties of its translation from Russian into Arabic
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This article discusses a discussion of trends and patterns of understanding and application of the concept of metaphor to various subjects that may interfere with the perspective of metaphors in translation theory, an attempt was made to use the principles and characteristics of metaphors and their fundamental tradition in translation theory, and to uncover the perspective of considering metaphor as a conceptual process. presenting its merits, since it is still considered an eccentric expression of linguistics.

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
The Intellectual as an Alien: A Study of Henry James's The Beast in the Jungle and James Joyce's "A Painful Case"
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This research paper studies the alienation of the intellectuals in the modern novel through the study of two alienated characters, John Marcher in Henry James's The Beast in the Jungle, and Mr. Duffy in James's Joyce's "A Painful Case." As a result of the complexity of life in the industrial societies, the individuals, especially the intellectual ones, feel themselves unable to integrate into social life; they fear society and feel that it endangers their individuality and independence. Thus, these characters live on the fringe of the societ

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Publication Date
Sat Jan 01 2022
Journal Name
Swinburne University Of Technology
Numerical Modeling of Flow through Foam Nodes in the Presence of Solid Particles for Foams within the Dry Limit and for Foams that are Approaching the Wet Limit
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Publication Date
Fri Feb 09 2024
Journal Name
Pharmacia
Evaluation of types and concentration of bile salts impact on physical properties of nisoldipine-loaded bilosomes
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Background: Bilosomes are lipid vesicles that exhibit flexibility and deformability. They consist of phospholipids and amphiphilic bile salts. Compared to the normal vesicular systems such as liposomes and niosomes, bilosomes provide several notable advantages, including simplified manufacturing, cost-effectiveness, and enhanced stability.

Aim: The main objective of the present work was to evaluate the effect of different bile salts on the physical properties that include entrapment efficiency, vesicle size, and polydispersity index(PDI). In addition, in vitro drug release for nisoldipine (NSD) loaded bilosomes was evaluated.

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Structural and optical properties of CdO and CdO0.99Cu0.01 thin films prepared by pulsed laser deposition technique
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Structural and optical properties of CdO and CdO0.99Cu0.01 thin
films were prepared in this work. Cadmium Oxide (CdO) and
CdO0.99Cu0.01semiconducting films are deposited on glass substrates
by using pulsed laser deposition method (PLD) using SHG with Qswitched
Nd:YAG pulsed laser operation at 1064nm in 6x10-2 mbar
vacuum condition and frequency 6 Hz. CdO and CdO0.99Cu0.01 thin
films annealed at 550 C̊ for 12 min. The crystalline structure was
studied by X-ray diffraction (XRD) method and atomic force
microscope (AFM). It shows that the films are polycrystalline.
Optical properties of thin films were analyzed. The direct band gap
energy of CdO and CdO0.99Cu0.01 thin films were determined from
(αhυ)1/2 v

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of sports marketing in achieving the competitive superiority of the organization: a case study in a sample of the Iraqi Premier League clubs
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The organization of sporting activities at the local and international levels requires a lot of money, which has increased interest in marketing in the sports field, as it is one of the modern topics that represent the basic knowledge needed by the sports marketer and which represents one of the basic concepts to enhance the benefits and returns of sports clubs. The research problem was the weak awareness of the members of the administrative body of Iraqi sports clubs of the role of sports marketing in the dimensions of competitive superiority and not exploiting them in the optimal way that enables clubs to achieve competitive superiority. The research aims to know the role of sports marketing in competitive superi

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Publication Date
Mon Dec 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison of enamel color alteration between bonded and free unbonded surfaces of maxillary anterior teeth after fixed orthodontic therapy (A prospective clinical study)
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Background: The purpose of this study is to compare the color changes between the bonded middle third and the unbonded gingival and incisal thirds, fallowing fixed orthodontic treatment Material and method: The color parameter l, a, b has been recorded for each thirds in upper anterior teeth by mean of easy shad device. The has been calculated for gingival, middle and incisal thirds for the upper anterior teeth in 34 patient, 17 males and 17femals, those subject undergone fixed orthodontic treatment Results: The in middle bonded third is highly significant higher than that in incise and gingival thirds p<0.01 because the middle third isn’t expose to oral fluid and dental brushing since it covered by the bracket. Also there

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Publication Date
Wed Feb 06 2019
Journal Name
Journal Of The College Of Education For Women
The Effect use of the Internet in Academic Libraries A Case Study
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The aim of this research is to show the importance of the effective use
of the internet in academic libraries; to improve the services and to increase
the competence of librarians.
The research has given some recommendations to improve the quality
of services and the need for cooperative network among academic libraries.

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Publication Date
Fri Jul 30 2021
Journal Name
Turkish Online Journal Of Qualitative Inquiry (tojqi)
A Pragmatic Study of the Student-Teacher Relationship in the Dangerous Minds
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