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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
Sat Jan 01 2022
Journal Name
Journal Of Stomatology
Preferences of treatments and materials used in the management of exposed pulps: a web-based questionnaire study
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Publication Date
Thu Aug 22 2019
Journal Name
International Journal Of Advancement In Social Science And Humanity
A CRITICAL DISCOURSE ANALYSIS STUDY OF PERSUASION IN THE LANGUAGE USED IN THE ELECTION CAMPAIGNS BY AMERICAN PARLIAMENTS
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BN Rashid

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Publication Date
Fri Aug 22 2025
Journal Name
Al–bahith Al–a'alami
The Role of Media Coverage of the Iraqi Satellite Channels in Shaping Public Attitudes towards Terrorism (a Field Study of a Sample of an Audience of the City of Baghdad)
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Violence is one of the most serious threats facing societies because it affects their internal structure and threatens the security and stability of society. It is classified as one of the types of security crises that are emerging in Arab and Islamic societies in particular, and in most countries of the world in general.

The threat of this crisis is increasing. Terrorism is considered as one of the most serious aspects of that all the countries of the world, currently, suffer from. The terrorism has begun to penetrate deep into society in one way or another starting from the Second World War, which led to the emergence of leftist movements in Western Europe, Japan, France, Italy and other countries as a result of emerging ideas

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to comp

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The role of the leader in empowering workers Application study in a sample of Iraqi telecom companies - Asia-Cell model
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Abstract

Leadership has now become a process for applying methods and techniques that make the Organization at the top of its competitive pyramid a greater market share. Leadership has become a focus for all leaders and managers، and leaders and managers are increasingly seeking to develop their skills and leadership skills. The research started with a clear problem of specific questions to ensure that the general objective of the research is to describe the characteristics of the leader and to clarify the dimensions of empowering the workers and to highlight the role of the leader in empowering the workers. The study examines the relation between the role of the leader in

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Publication Date
Wed Jun 01 2005
Journal Name
Journal Of The College Of Languages (jcl)
The Picture of the romantic hero in: A Bridge Towards the Basific and The Lover
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This research deals with number of novels for Marguerit Doras , specially A Bridge Towards Basfic and The Lover . we specialize the first chapter for discussing a very important issue , which is the Maraguerit Doras novelist world in another word the most important themes . that we discuss and through that we tried to clerify the privacy the characters of Marguerit Doras in comparative with her own generation and in the second chapter we discussed the most important characteristics of the romantic hero spedially the characteristics of women in her novels.

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Publication Date
Wed Jul 26 2023
Journal Name
Journal Of Aridland Agriculture
Modern GPS diagnostic technique to determine and map soil hardpan for enhancing agricultural operation management
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Among the undesirable effects of soil compaction is a measurable reduction in plant growth and crop yield. The prevailing belief is that compacted tillage pans are caused by repetitive farming practices, heavy tractors, tillage tools, and field traffic. This experiment was conducted to determine and map the hardpan layers across an agricultural field through advanced technologies of precision agriculture. These valuable techniques such as data logger, yield map, and data analysis of performance indicators were linked with accurate global positioning systems (GPS) datasets. These important technologies provided the farmers and helped them to identify and manage areas of the fields with higher compacted layers. Three ground speeds 4.3

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
Analytical study of the images and roles of women and men in the books of the Arabic language at the elementary level
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Importance of the research:
The importance of any educational or scientific research through its intellectual arena of facts supply the individual and society, Supports Knowledge and Science Group, which raised will be locked in these topics in the future.
This research seeks to shed light on the image and the role of women and men in the books of the Arabic language in primary education (primary), To illustrate the negative effects of the phenomenon of sexism in textbooks, And its negative impact on emerging, And stay away as much as possible about the distinction between the sexes in the roles and qualities in textbooks traditional stereotypes and remove that put both sexes templates hinder the development of the individual and t

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Publication Date
Thu Nov 03 2016
Journal Name
Int. J. Pharm. Sci. Rev. Res.
Impacts of simultaneous administration of omega-3 fatty acids with amoxicillin/clavulanic acid on albino rats' liver and bile
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Most drugs undergo some metabolism in the liver before excretion by the kidneys or bile. Thus, it is not surprising that liver injury may be provoked due to its exposure to various drugs and compounds. Drug-induced cholestatic liver injury may occur particularly under conditions of increased drug concentrations, genetic alterations in expression of enzymes or transporters. Additionally, the drug-induced cholestasis can be caused by direct toxic effects of drugs or their metabolites on different hepatic cell types or through an immune-mediated process. Amoxicillin/ clavulanic acid, an antibiotic that is therapeutically utilized for the treatment of a number of bacterial infections. Omega-3 fatty acids are unsaturated fatty acids that have ro

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