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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
Mon Sep 30 2024
Journal Name
Medical Journal Of Babylon
Effectiveness of Deep Breathing Technique on Pain Level of School Children during Catheterization
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Publication Date
Thu Jun 02 2016
Journal Name
مجلة العلوم التربوية والنفسية
The effect of the K.W.L.Plus strategy in developing the mental skills and reflective thinking of first-year middle school female students
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Publication Date
Fri Sep 01 2017
Journal Name
Journal Of Baghdad College Of Dentistry
In Vitro the Effect of Canals Instrumented with Three Rotary Ni-Ti Systems on the Dislocation Resistanceo Guttafusion ® versus Single Cone Obturation Technique
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Background: Complete seal of the root canal system following its chemo-mechanical debridement plays a pivotal role for achieving successful endodontic treatment. This can be established by reducing the gaps between the core filling material and root canal wall. Aim: To assess and compare the dislocation resistance of root canals obturated with GuttaFusion® and TotalFill BC sealer versus single cone obturation technique and TotalFill BC sealer after instrumentation of the canals with WaveOne, ProTaper Next and ProTaper Universal system. Material and Method: Sixty extracted human permanent mandibular premolars were conducted in the current study. The teeth were decorated and left the root with 15mm length; the roots were divided randomly i

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of KUD Strategy on Acquiring Grammatical Concepts among First Intermediate Students
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The research aims to examine the effect of KUD strategy on acquiring the grammatical concepts among intermediate school students. To achieve the research objective, the researcher adopted the null hypothesis in which there is no statistically significant difference at the level (0.05) between the average scores of students of the experimental group who study grammar base on the KUD strategy and the average scores of the control group who study the grammar through the traditional way of acquiring grammatical concepts. In a random manner, the researcher selected the research sample from one of Baghdad’s education schools in al Rusafa / 2, as the total number of students of the two groups reached (67) students. They were divided into (33)

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Publication Date
Thu Jun 20 2030
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Sat Jan 01 2022
Journal Name
Maced J Med Sci.
Past Myocardial Infarctions and Gender Predict the LVEF Regardless of the Status of Coronary Collaterals: An AI-Informed Research. Open Access Maced …
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BACKGROUND: The degree of the development of coronary collaterals is long considered an alternate–that is, a collateral–source of blood supply to an area of the myocardium threatened with vascular ischemia or insufficiency. Hence, the coronary collaterals are beneficial but can also promote harmful (adverse) effects. For instance, the coronary steal effect during the myocardial hyperemia phase and that of restenosis following coronary angioplasty.

Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
On the Use of the First-Person Pronoun ‘we’ in Final-Year Master Projects of South Algerian EFL Students
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Literature on the use of the first-person pronoun in abstracts and conclusion sections of final-year projects is limited. In case of Algerian Master students, it is too scant. The present paper aims at filling this gap through a study concerned with students’ and engagement in their final projects (memoirs). This quantitative study examines the use of “we” and its various types, “our- us-I, my, the researcher” in memoirs chosen at random from the d-space portal of the University of Adrar, southern Algeria. Sixty-five papers, submitted in the fields of Linguistics or didactics between 2015 and 2020 and representing nearly half of the whole memoirs’ depository at the library’s d-space, constituted the corpus of study. The des

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Publication Date
Mon Jan 23 2023
Journal Name
Journal Of Cellular And Molecular Medicine
The efficacy of non‐surgical platelet‐rich fibrin application on clinical periodontal parameters and periostin level in periodontitis: Clinical trial
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Abstract<p>Platelet‐rich fibrin (PRF) has been widely used in regenerative dentistry due to many growth factors produced. Periostin, a matricellular protein, is a reliable marker for tissue regeneration. Periostin is part of the cellular matrix and regulates bone homeostasis. This study aims to explore the efficacy of PRF in improvement of the clinical periodontal parameters as an adjunct to the scaling and root planing and to evaluate periostin level in gingival crevicular fluid (GCF) at baseline, 1‐ and 3‐month recall visits. Fourteen periodontitis patients who met the inclusion criteria were recruited in this study. Two contralateral periodontal pockets with 4–6 mm in depth in each patient were sel</p> ... Show More
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Publication Date
Thu Aug 24 2023
Journal Name
Migration Letters
The Effect of Electronic Educational Games on the Information Generation Skills of the First Intermediate Grade Students in Mathematics
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