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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
Thu Dec 15 2022
Journal Name
Al-academy
The art of adornment and make-up in the ancient civilizations of Mesopotamia and the old country of Yemen as a model
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This research sheds light on those discrepancies in the use of ornaments, adornment and perfumes, as well as the art of cosmetics, in two important civilizations, namely, the Mesopotamian civilization as the earlier civilization, and the civilization of Yemen, which represents the first Arab civilization. Through the foregoing, our research includes two topics, the first topic included the history of the use of decorations, ornaments and perfumes in the civilization of Mesopotamia, while the second topic included the study of ornaments, adornment and cosmetic art in the ancient civilization of Yemen. And then the research came out with a number of conclusions that the researcher considers very important to highlight the differences and f

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Publication Date
Fri Oct 25 2024
Journal Name
The Review Of Contemporary Scientific And Academic Studies
The Representation of Men and Women in the Black and White Streams of the Second Wave of Feminism: A Corpus Stylistic Analysis
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Publication Date
Sat Jan 30 2021
Journal Name
مجلة الجامعة العراقية
Organizational Sources of Burnout and determinants of work Performance in light of the COVID-19 Pandemic: a field study of a Sample of Workers in Social Protection Agencies in Iraq)
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The problem of job burnout has become one of the main problems for researchers in social welfare organizations (social protection bodies) - one of the formations of the Ministry of Labor and Social Affairs. Its negative effects increased in light of the COVID-19 pandemic, and in light of the Corona pandemic, the pressures and burdens of workers varied, which resulted in high rates of anxiety, tension, and intellectual and physical exhaustion, and then negatively affected their efficiency in performing work at the individual and organizational level, especially after the increasing tasks of these Bodies in carrying out their role in achieving the general goals and objectives as beingThe general goals are that they are responsible for providi

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Publication Date
Mon Dec 18 2017
Journal Name
Agronomy
A Case Study of Potential Reasons of Increased Soil Phosphorus Levels in the Northeast United States
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Recent phosphorus (P) pollution in the United States, mainly in Maine, has raised some severe concerns over the use of P fertilizer application rates in agriculture. Phosphorus is the second most limiting nutrient after nitrogen and has damaging impacts on crop yield if found to be deficient. Therefore, farmers tend to apply more P than is required to satisfy any P loss after its application at planting. Several important questions were raised in this study to improve P efficiency and reduce its pollution. The objective of this study was to find potential reasons for P pollution in water bodies despite a decrease in potato acreage. Historically, the potato was found to be responsible for P water contamination due to its high P sensitivity a

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Publication Date
Sun Mar 02 2014
Journal Name
Baghdad Science Journal
We study the effect of Ultra violet rays (A-B) in treatment of Vitiligo (applied Therapy)
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This research evaluated the effect of (UV)(400-320A)Hz(320-220B)Hz on the patient with vitiligo , using it with our new combing therapy that include the oral (Psorlene ) topical , meladinine solution applied on the Vitiligiousns Lesions , In edition to the instralesnional injection in the Vitiligiousns Lesions by long acting steroid (kenacort-A ) by aprecentage of (5%) , after that we expose the patient to UV . The ruslets of this way of treatment more effective by using of the UV rays in the treatment of vitiligo , while the previous treatment that used the UV ray with or with out the psorlene , the results were not effective on controlling of the Vitiligio diseases comparing by the treatment used in this research as it stop’s the sp

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of managing organizational diversity in achieving success Exploratory study in the Ministry of Industry and Minerals
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The aim of the research is to demonstrate the impact of organizational diversity management on achieving success, The problem of research is to create an appropriate work environment that stimulates everyone regardless of each dimension of diversity, So as to reach the best levels of success, The importance of research is to identify how the organization in question can manage organizational diversity effectively and contribute to its success, The research started from two main hypotheses which were derived from sub-hypotheses to identify the correlation and influence between the search variables by analyzing the answers of the research sample which included (81)

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Publication Date
Mon Aug 07 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study the Effect of Rifampicin in the Level of Thyroid's Gland Hormones and Thyroid - Stimulating Hormone in Rabbits
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The aim of this study was intended to study the effect of rifampicin in the level of thyroid's gland hormones (T4 ØŒT3) and thyroid -stimulating hormone (TSH) in rabbits.            Eight male rabbits were used through out this study, their weights were measured before the starting of the experiment. Animals were divided into two groups (each group contains 4 rabbits), the first group was administrated daily with 15 mg/Kg physiological normal saline for 35 days and used as a control group, while the second group was administrated with 15 mg /Kg daily for 35 day of rifampicin capsule 300 mg.       At the end of the experiment, all of animal groups were

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
Discretionary Punishment (Al-Ta'zir) for the Interest and its Effect in Keeping the Public Regulation A Fundamental Applied Study in the Saudi Arabian Courts
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Discretionary Punishment, Public Regulation, Interest

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
Performance difficulties of Sharif Muhiyddin Haider’s musical works among Oud students
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This research focuses on the difficulties that face Oud's students' in the performance of Sharif Muheyddin Haider musical works. In addition, this research suggests solutions to overcome these difficulties for make it easier to play Haider's musical works. This research also addressed important topics of great relevance the title, problem and the research's aims. Moreover, Procedures of this research adopted the descriptive approach (content analysis) to attain the research's aims. Furthermore, results and discussions where covered, and conclusions of the appropriate academic solutions were achieved to overcome the performance difficulties of Haider's musical works among Oud's students'. At the end, the research presents a set of recomme

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Publication Date
Tue Jun 06 2017
Journal Name
International Journal Of Science And Research (ijsr)
Facing Uncertainty Dimensions by Depending on Strategic Conversation,
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The research starts from a fundamental problem about how top management team can realize the uncertainty. Strategic conversation has been introduced as a way for top management team to deal with uncertainties. Within the current research model, the strategic conversation was considered as an independent variable and uncertainty as dependent variable. The researcher used the survey method by distributed a questionnaire in the Administration and Economics College, University of Baghdad. Samples are 40 faculty participant of scientific committee members were distributed in seven scientific departments. The data were statistically analyzed by mean and the standard deviation. The hypotheses were tested through the use of correlation and regressi

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