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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 Jul 01 2017
Journal Name
Journal Of Biological Chemistry
Functional and phylogenetic evidence of a bacterial origin for the first enzyme in sphingolipid biosynthesis in a phylum of eukaryotic protozoan parasites
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Publication Date
Thu Oct 15 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Iraqi Women with Preeclampsia: Maternal and Neonatal Outcomes
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BACKGROUND: Preeclampsia (PE) is a possible etiology of obstetrical and neonatal complications which are increased in resource-limited settings and developing countries. AIM: We aimed to find out the prevalence of PE in Iraqi ladies and specific outcomes, including gestational weight gain (GWG), cesarean section (CS), preterm delivery (PD), and low birth weight (LBW). METHODS: All singleton pregnant women visiting our tertiary center for delivery were involved over 3 years. PE women were compared with non-PE ladies. Complete history and examination were done during pregnancy and after delivery by the attending obstetrician and neonatologist with full documentation in medical records. RESULTS: PE prevalence was 4.79

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Publication Date
Thu Jun 20 2024
Journal Name
Acta Facultatis Medicae Naissensis
Clinical properties and seminal fluid analysis of patients with primary infertility consulting the urology outpatient clinic for the first time: A cross-sectional study
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Introduction/Aim. Seminal fluid analysis (SFA) plays a crucial role in helping infertility clinics diagnose the underlying reason of male infertility. The aim of the study was to investigate seminal fluid patterns of male partners of an infertile couple with apparently fertile female partners. Materials and methods. A cross-sectional study was conducted between January 2019 and December 2022. Patients were attending consultations for delayed conception for more than 12 months with apparently fertile female partner. Results. Four hundred fifty-three patients were included in the study. The distribution of patients according to age groups showed that 277 patients were young, aged 21 - 30 years (61%). Two hundred sixty-two (58%) patien

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Publication Date
Fri Oct 09 2026
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
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
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 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
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
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
Wed Jan 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The problems faced by First-grade intermediate students in studying the Arabic language
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This study investigates the challenges encountered by first-grade intermediate students in learning the Arabic language. It aims to identify specific obstacles that hinder language acquisition and proficiency among this demographic. Through qualitative and quantitative methods, including surveys and interviews with students, teachers, and parents, the research highlights key issues such as limited vocabulary, difficulties in grammar, lack of engagement with the material, and inadequate teaching resources. The findings reveal a complex interplay between cognitive, social, and educational factors that contribute to these challenges. The study underscores the need for targeted interventions, such as enhanced pedagogical strategies and improved

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