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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
Tue Mar 18 2025
Journal Name
Physica Scripta
Design and Analysis of a highly sensitive open trapezoidal channel PCF-based Plasmonic Refractometric Sensor
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Abstract<p>This study introduces a highly sensitive trapezium-shaped PCF based on an SPR refractometric sensor with unique design features. The structure of a sensor was designed and analyzed using COMSOL Multiphysics v5.6 based on Finite Element Method (FEM) with a focus on investigating the influence of various geometric parameters on its performance. The two channels were coated with a metallic gold layer to provide chemical stability, and a thin layer of TiO₂ improved the gold's adhesion to the fiber. The findings indicate that the proposed sensor achieves maximum amplitude and wavelength sensitivities of 1,779 RIU⁻¹ and 30,500 nm/RIU, respectively, with corresponding resolutions of 3.2</p> ... Show More
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Publication Date
Thu Mar 01 2018
Journal Name
International Journal Of Oral And Maxillofacial Surgery
Assessment of facial asymmetry before and after the surgical repair of cleft lip in unilateral cleft lip and palate cases
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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The beginning of culturally renaissance in Arab Gulf region in the first half from 20th century
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The present paper deal with the issue of the beginning of the culturally
renaissance in emirates of Arab Gulf from 1914-1945 between tow world war
has been attracting the attention of academic about the developments in many
fields in the Arab Gulf at this time.
The paper is divided into five sections. First section, deals with the
geographic importance for the Arab Gulf region. Second section, the economic
situations in the region before and after oil. The third section, talk for social
situations, like population, tribe and tribes in society, and immigration. The
fourth section, deals with the factors of rise the culture and political in the Arab
Gulf before discovery of oil period. The five section, the cultu

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Cognitive Effects of Tumor and Surgical Treatment in Patients with Cerebral Gliomas
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Background: Quality of life in brain tumor patients is an emerging issue and has prompted neurosurgeons to recon¬sider the need for cognitive assessment in the course of treatment. To date there has been a lack of comprehensive neuropsychological assessment performed preoperatively and in the acute postoperative period in our hospitals.Objectives: to establish the effects of tumors and their surgical treatment, from a neuropsychological perspective, on cognitive functioning in patients with cerebral Gliomas. Methods: This is a prospective study conducted in the Neurosurgical Hospital in Baghdad, Iraq, during the period from January 1999 to January 2001. Any patient admitted during the period of the study with clinical history, signs, sy

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Social Studies Teachers' Perceptions of the Importance of Employing Twenty-First Century Skills in Teaching
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The study aimed to identify the perceptions of social studies teachers in the Governorate of Muscat about the importance of employing the skills of the twenty-first century in teaching. The study employed a qualitative approach. The two researchers used an analytical approach based on the Grounded Theory, the data was gathered through semi-structured interviews with (15) male and female teachers. The results indicated that social studies teachers relate the twenty-first-century skills more to improving students’ achievement level in the subject, while they see that these skills have less influence in developing students’ communication skills and cooperation with their peers. In light of the results of the study, the two researchers r

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Publication Date
Sun Jul 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Carin Model in The Achievement of The First Intermediate Grade Students and Their Reflective Thinking in Physics Subject.
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The Current research aims to identify ( the effect of Carin model in the achievement of the first intermediate Grade Students and their Reflective Thinking in physics Subject ) the researcher selected the experimental design with a partial adjust , The research sample consisted of ( 47 ) Students with ( 23 ) Students in the experimental group and ( 24 ) Students in the control group , The two groups rewarded in the variables chronological age in months , Reflective Thinking and the degrees in physics in the first course. The researcher coined the purposes of behavioral which belong to chapter fifth, sixth, and seventh of physics books scheduled of the school year ( 2015-2016 ) and prepared appropriate lesson plans for the two experimenta

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Publication Date
Tue Nov 01 2011
Journal Name
Case Reports In Dermatological Medicine
Neuropathy dermatitis following surgical nerve injury
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KE Sharquie, AA Noaimi, AS Alaboudi, Case Reports in Dermatological Medicine, 2011 - Cited by 24

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of the Serum Level of Interleukin-6 in Patients Undergoing Surgical Removal of Impacted Mandibular Third Molars
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Evaluation of the Serum Level of Interleukin-6 in Patients Undergoing Surgical Removal of Impacted Mandibular Third Molars, Hussain A Taher*, Salwan Y Bede

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Matrix Form of Deriving High Order Schemes for the First Derivative
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For many problems in Physics and Computational Fluid Dynamics (CFD), providing an accurate approximation of derivatives is a challenging task. This paper presents a class of high order numerical schemes for approximating the first derivative. These approximations are derived based on solving a special system of equations with some unknown coefficients. The construction method provides numerous types of schemes with different orders of accuracy. The accuracy of each scheme is analyzed by using Fourier analysis, which illustrates the dispersion and dissipation of the scheme. The polynomial technique is used to verify the order of accuracy of the proposed schemes by obtaining the error terms. Dispersion and dissipation errors are calculated

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Publication Date
Mon Aug 03 2020
Journal Name
Rawal Medical Journal
Surgical fixation and grafting of traumatic distal tibia atrophic nonunion with or without platelet-rich plasma: A comparative study
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Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group

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