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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 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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Publication Date
Sat Apr 04 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
Regularity via semi-generalized open set
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In this work the concept of semi-generalized regular topological space was introduced and studied via semi generalized open sets. Many properties and results was investigated and studied, also it was shown that the quotient space of semi-generalized regular topological space is not, in general semi-generalizedspace.

Publication Date
Sat Apr 01 2023
Journal Name
Full Text Book Of Minar Congress8
REGULARITY VIA PRE- GENERALIZED OPEN SETS
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By use the notions pre-g-closedness and pre-g-openness we have generalized a class of separation axioms in topological spaces. In particular, we presented in this paper new types of regulαrities, which we named ρg­regulαrity and Sρg­regulαrity. Many results and properties of both types have been investigated and have illustrated by examples.

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Publication Date
Wed Apr 03 2013
Journal Name
The Official Journal Of Iraqi Board For Medical Specialization
Presentation and management outcomes of eclampsia at Al-Elwiyah teaching hospital
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Publication Date
Mon Jul 01 2024
Journal Name
World Neurosurgery
Orbital Rhabdomyosarcoma: Comprehensive Review of Epidemiology, Clinical Staging, and Treatment Outcomes
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Publication Date
Sun Jul 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Lead Time Strategy on the First Intermediate Class Pupils' Achievement in Geography
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The study aims at finding out the effect of the lead time strategy on the first intermediate class pupils' achievement in geography The partial experimental design of two groups, experimental and control, with pre-post tests is used. The sample is represented in (73) female pupils. The sample is divided into two groups (37) experimental group and (36) control one. The sam ple is selected from first intermediate class pupils ( Al Batol intermediate school for girls) Baghdad Al-karkh-3, for academic year 2015-2016 The researcher has equalized the two groups in several variables: the previous achievement tests, intelligence, age in months, the scores of geography test of first course

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Publication Date
Wed Apr 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Prediction the widths of maxillary and mandibular canines and premolars from the widths of maxillary incisors and first molars (Iraqi study)
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Background: This study aimed to use the combined mesio-distal crowns widths of maxillary incisors and first molars as predictors to the combined mesio-distal crowns widths of maxillary and mandibular canines and premolars. Materials and methods: The sample included 110 Iraqi Arab subjects with an age ranged between 17-25 years and class I skeletal and dental relations. The crown widths of maxillary teeth and mandibular canines and premolars were measured at the largest mesio-distal dimension on the study casts using digital electronic caliper with 0.01 mm sensitivity. Pearson’s correlation coefficient was used to determine the relation between the combined mesio-distal crowns widths of maxillary incisors and first molars and the combined

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Detection of early occlusal caries of the first permanent molar using different techniques (An in vivo study)
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Background: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths to establish adequate preventive measures and avoid premature tooth treatment by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for the detection of initial occlusal caries in noncavitated first permanent molars. Materials and Methods: This study examined 139 occlusal surface of the first permanent

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Publication Date
Wed Apr 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparative Study between Flapped and Flapless Surgical Techniques in Dental Implant Stability According to Resonance Frequency Analysis
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Background: Recent implant surgical approach aims to cause less trauma, invasiveness and pain as much as possible and to reduce patient and surgeon discomfort, time of surgery and time needed for functional implant loading. Flapless surgical techniques considered recently as one of the most popular techniques that may achieve these aims especially enhancing osseointegration and subsequently implant stability within less time than the traditional flapped surgical technique. So this study aimed to make a comparison between flapped and flapless surgical techniques in resulted implant stability according to resonance frequency analysis RFA and in duration of surgical operation. Materials and methods: A total of 26 patients with 41 implants (o

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Application of Finite Element Technique: A Review Study
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The finite element approach is used to solve a variety of difficulties, including well bore stability, fluid flow production and injection wells, mechanical issues and others. Geomechanics is a term that includes a number of important aspects in the petroleum industry, such as studying the changes that can be occur in oil reservoirs and geological structures, and providing a picture of oil well stability during drilling. The current review study concerned about the advancements in the application of the finite element method (FEM) in the geomechanical field over a course of century.

Firstly, the study presented the early advancements of this method by development the structural framework of stress, make numerical computer solution

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