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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
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Cavity preparation model in rat maxillary first molars: A pilot study
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Objective: To conduct a standardized method for cavity preparation on the palatal surface of rat maxillary molars and to introduce a standardized method for tooth correct alignment within the specimen during the wax embedding procedure to better detect cavity position within the examined slides. Materials and methods: Six male Wistar rats, aged 4-6 weeks, were used. The maxillary molars of three animals were sectioned in the frontal plane to identify the thickness of hard tissue on the palatal surface of the first molar which was (250-300µm). The end-cutting bur (with a cutting head diameter of 0.2mm) was suitable for preparing a dentinal cavity (70-80µm) depth. Cavity preparation was then performed using the same bur on the tooth

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Using GIS Technique for evaluating water quality of Abu Zarag marsh during the flood season
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Abstract<p>This research deals with the most important heritage in Iraq, which are the Iraqi marshes, especially Abu Zarag marsh in Al-Nasiriyah city south of Iraq. The research is divided into two parts. The first part deals with evaluating the water quality parameters of Abu Zarag marsh for the period from December 2018 to April 2019 which is the flooding season. The parameters are Temperature, pH, Electrical Conductivity, Total Dissolved Solids, Alkalinity, Total Hardness, Turbidity, Dissolved Oxygen, Sulfate, Nitrate. The second part is a comparison between the water quality parameters during the recent period with the same period during the previous years from 2014 to 2019. The results are </p> ... Show More
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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
the director and the technique of theatrical extemporization
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Extemporization is the ability of the actor to reflect his internal being. It gives a sort of confidence and an ability to show the personal countenance of the role away from tension and rigidity. By extemporization, it is possible to deal with and criticize the real living life so it is an intellectual, emotional, sensual, and perceptive process connected with the psychological energy and the emotional memory and all this goes under the control of the director and his instigations and instructions depending on what the text involves of intellectual, social and psychological motivators so it primarily depends on talent, chance and discussion. The research involves four chapters; the first contains the problem

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Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
open-source enterprise resource planning system Odoo roll in rationalizing the costs of the Ishtar Sheraton Hotel/ applied research
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The Accommodation industry in Iraq suffers from many problems, especially after 2003, when the Accommodation industry was exposed to many crises due to the security and political situation in Iraq, which negatively affected the administrative operations inside the industry and created many problems, the most important of which are deterioration, high costs and poor performance, so some hotel administrations sought To find alternative solutions that help in the advancement of hotels, one of the proposals is to go to technology, as technology is currently one of the most important solutions to solve large complex problems, as the world has turned to automation to solve complex problems such as increasing production, reducing costs, and rai

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Publication Date
Sat Jan 31 2015
Journal Name
International Journal Of Advanced Research
BK polyomavirus and Cytomegalovirus Co-infections in renal transplant recipients: a single center study
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Background: Opportunistic viral infections make an important threat to renal transplantation recipients (RTRs), and with the use of more intense newly-developed immunosuppressive drugs; the risk of renal allograft loss due to reactivation of these viruses has increased considerably. At the top priority of these viruses lie BK polyomavirus (BKV) and human cytomegalovirus (CMV). Reactivation of these viruses in these chronically immunosuppressed RTRs can lead to renal impairment and subsequently allograft loss, unless early detected and properly treated. Objectives: The study aimed to detect and quantify plasma viral load of BKV and CMV in RTRs using quantitative real time PCR (qRT-PCR), in order to study the prevalence of these two viruses i

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Publication Date
Mon Apr 01 2019
Journal Name
Biochemical & Cellular Archives
The impact of follicular fluid growth differentiation factor 8 levels on IVF /ICSI outcomes
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Clinical index is needed to predict the outcome of pregnancy after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for infertile patients. Growth differentiation factor-8 (GDF-8), also known as myostatin, is one of transforming growth factor-â superfamily localized in antral follicles in normal and PCOS ovaries but its function in female reproductive system is still unknown. Aim of the study is to assess the correlation between levels of GDF8 in follicular fluid (FF) with outcomes of in vitro fertilization (IVF/ICSI) in women with and without PCOS. A prospective case control study was performed enrolling (40) patients with PCOS and (40) non-PCOS women (male infertility) undergoing IVF/ICSI. The collect

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Use of lower squares and restricted boxes In the estimation of the first-order self-regression parameter AR (1) (simulation study)
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Use of lower squares and restricted boxes
In the estimation of the first-order self-regression parameter
AR (1) (simulation study)

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Publication Date
Sat Dec 31 2022
Journal Name
Mathematical Modelling Of Engineering Problems
Experimental and Numerical Study of Open Channel Flow with T-Section Artificial Bed Roughness
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Experimental and numerical studies have been conducted on the effects of bed roughness elements such as cubic and T-section elements that are regularly half-channel arrayed on one side of the river on turbulent flow characteristics and bed erosion downstream of the roughness elements. The experimental study has been done for two types of bed roughness elements (cubic and T-section shape) to study the effect of these elements on the velocity profile downstream the elements with respect to different water flow discharges and water depths. A comparison between the cubic and T-section artificial bed roughness showed that the velocity profile downstream the T-section increased in smooth side from the river and decrease in the rough side

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Publication Date
Wed Jan 01 2020
Journal Name
Transplantation Proceedings
Outcomes of SGLT2 Inhibitors Use in Diabetic Renal Transplant Patients
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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Cranio-maxillofacial Surgery
Assessment of regional asymmetry of the face before and after surgical correction of unilateral cleft lip
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