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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 Feb 01 2023
Journal Name
32nd Annual Meeting North American Skull Base Society
Surgical Reexploration of a Cerebral Arteriovenous Malformation Remnant: Literature Review and Illustrative Case
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Publication Date
Wed Jan 01 2020
Journal Name
Construction Research Congress
Exploratory Study of Potential Negative Safety Outcomes Associated with UAV-Assisted Construction Management
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Publication Date
Tue Jan 09 2018
Journal Name
International Journal Of Medical Research & Health Sciences
Assessing the Period between Diagnosis of Breast Cancer and Surgical Treatment among Mastectomized Female Patients in Iraq
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Introduction: Breast cancer is the most common cancer and the major cause of cancer related deaths among Iraqi women. Due to the relatively late detection of breast cancer, the majority of the patients are still treated by modified radicle mastectomy. Aim: To assess the time lag between diagnosis of breast cancer and mastectomy among Iraqi patients; correlating the findings with other clinicopathological characteristics of the disease. Patients and methods: This retrospective study enrolled 226 Iraqi female patients who were diagnosed with breast cancer. Data were registered on the exact time period between signing the histopathological report and the surgical treatment. Other recorded variables included the age of the patients, their level

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Publication Date
Mon Jul 01 2019
Journal Name
International Journal Of Medical Research & Health Sciences
Assessing the Period between Diagnosis of Breast Cancer and Surgical Treatment among Mastectomized Female Patients in Iraq
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Introduction: Breast cancer is the most common cancer and the major cause of cancer related deaths among Iraqi women. Due to the relatively late detection of breast cancer, the majority of the patients are still treated by modified radicle mastectomy. Aim: To assess the time lag between diagnosis of breast cancer and mastectomy among Iraqi patients; correlating the findings with other clinicopathological characteristics of the disease. Patients and methods: This retrospective study enrolled 226 Iraqi female patients who were diagnosed with breast cancer. Data were registered on the exact time period between signing the histopathological report and the surgical treatment. Other recorded variables included the age of the patients, their level

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Publication Date
Sun Jun 21 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Enhancement of Aqueous Solubility and Dissolution Rate of Etoricoxib by Solid Dispersion Technique
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Etoricoxib (EXB) is a highly selective cox-2 inhibitor which belongs to the non-steroidal anti-inflammatory drug (NSAID). EXB is a class II drug according to the biopharmaceutical classification system (BCS), which possess a very low aqueous solubility in water.  In the present study, many trials were made to improve the aqueous solubility and dissolution rate of EXB by solid dispersion technique.

Eighteenth EXB formulas were formulated as a solid dispersion using a variety of hydrophilic polymers (as carriers)   including poloxamer 407 (PXM 407), poloxamer 188 (PXM 188) and polyethylene glycol 4000 (PEG 4000) at different drug: polymer ratios (1:1, 1:3 and 1:5). These formulas were prepared by two methods; solvent

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Guilt and its relationship with the self-awareness Educational research Open Educational College Students
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Targeted current research study of the relationship between guilt and self-consciousness and consisted of the research community of students from the open educational college, as has been selected students in the Department of Counseling and psychological science department and the researcher used guilt, prepared Scale (Ansari, 2003), and the measure of selfawareness prepared (Shammari 0.2000), and extracted his Alsekoumtria characteristics, Fastkhrjt alternatives after a presentation to a group of experts and specialists in the field of psychological counseling psychology, education, science and psychological validity and reliability Alvakronbach manner and retesting reaching reliability coefficient of guilt ((0.85) and awarenes

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Interdisciplinary Mathematics
On ⱨ - supra open sets in supra topological spaces
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The significance fore supra topological spaces as a subject of study cannot be overstated, as they represent a broader framework than traditional topological spaces. Numerous scholars have proposed extension to supra open sets, including supra semi open sets, supra per open and others. In this research, a notion for ⱨ-supra open created within the generalizations of the supra topology of sets. Our investigation involves harnessing this style of sets to introduce modern notions in these spaces, specifically supra ⱨ - interior, supra ⱨ - closure, supra ⱨ - limit points, supra ⱨ - boundary points and supra ⱨ - exterior of sets. It has been examining the relationship with supra open. The research was also enriched with many

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Outcome of surgical treatment of highgrade intramedullary astrocytomas
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Background: Intramedullary astrocytomas
account for about 1% of all CNS tumors and
6–8% of spinal cord tumors. The vast majority
of intramedullary astrocytomas are slowgrowing
lesions.
Objectives: The goal in this study was to
review a series of patients who underwent
surgical removal of intramedullary high-grade
astrocytomas, focusing on the functional
outcome and the effect of multimodality
treatment on the survival of patients with high
grade intramedullary astrocytoma.
Methods: Between June 1999 and June 2004,
22 patients underwent removal of
intramedullary high-grade astrocytomas in four
neurosurgical hospital in Baghdad/ Iraq
(Neurosurgical hospital, Al Shaheed Adnan
Hospital for

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Craniofacial Surgery
The First Patient Report of Tongue Abscess Among Iraqi Population
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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Association Between Carbamazepine Toxicity, Liver Bile Duct Injury, Granuloma and Inflammatory Cells Infiltration in Female Mice
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The liver is an important organ in the body that can be affected by many drugs and toxins. The hepatotoxins can cause oxidant stress that lead to activation of inflammatory cells and cause liver damage. Drug induced bile duct injuries are related to drug toxicity, multiple drugs have been known to cause the development of liver granulomas. Carbamazepine (CBZ) among other antiepileptic drugs is believed to cause hepatic injury. In this study we investigated the effect of (CBZ) 20mg/kg/day on female mice liver after 14 and 30 days of treatment. The histological findings showed that (CBZ) can cause histological alterations in the liver components such as bile duct proliferation, biliary hypertrophy, ductopenia, inflammatory cells infiltration

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